22 entries 3/15/10




Jan. 24,2011

I read a a passage in the book Who Moved My Cheese?......I gain a massage that I've been reminded time after time about how life. Basically saying with faith ALL things can be turn from bad into good. This qoute uplifted me from the long day I experienced early today.

Jan 26
I read a passage today from Mrs. Jocye Meyers.....It tells us that we are humans so of course we always planning goals but sometime never really complete the plans because its not realistic or just not deicated. She gave good advise about instead of saying "I want to lose 30 lbs in month say I plan to lose 5 pounds in four weeks so when you do you'll stay motivated and stick with it. Something to think about right?

Absolutely!

Jan 27
On my practice reading compass test today a passage about how education is really important in the United States more than 55% off high school students are high school drop outs. As a result most are not qualifed to get good jobs. Its so many scholarships offered to college students to further our education. Many do not take advantage of the help our government grant us. Being a young mother I have no choice to get an college degree to make a better life for me and my family. This passage hit home to me because I use all my student loans and Pell to provide.

I know it is hard, been there done that. I can only tell you it is worth it in the end. :)

Jan 28
Credit cards are not always a good choice. Many people are not fully aware of the charges disclose. I came across a article today discussing the cons of credit cards. Had I read my agreement to my Captial One card I would have nerver swiped the card. So many intrestes rates I was not expecting. I suggest if any college student use a credit card its for "emergence" only. If possible always use debit or cash so you want have any regrets in the long run.

This is a tough lesson, I learned mine a long time ago. By the time I paid off my washing machine on credit with interest, I could have bought two! (anne)

Jan. 31
Today I read a article about the problem of fashion. Over the years the main appeal of wearing expensive, new fashion was that wealthy clients could distinguish themselves from people who were less well off. Fashion helpded presevred the ordered layering of society into classes. Big named designers every season would show new styles in Paris,New York, or London. By 20th cenutury thanks to technological advances in clothes manufacturing it didn't take long to make inexpensive knock offs to trickle down to lower class.

Feb1
Today we discussed in class a story in our books about imates trainging dogs for veterns who are disable. Many people had great comments about is it fair for the imates to make a bound with the dog then the dog has to leave. My opioion was yes because they will soon get another dog.

Feb.2
Today was a looooooooong day to say. I read so much about the IRS laws a few years back I was audit for my taxes and every since then its been a headache I read this book Publication 596 about you have wait to years before you claim a dependent and they look at you retun for the next 10 years. It sucks to have people out there that take your money when you worked all year.
Feb 9
It's been nearly a year since Formula Capital's James Altucher discussed his theory on why sending your kids to college is a bad idea. The segment proved to be one of Tech Ticker's most popular...and controversial of 2010. I agree with him about try to own your own business or travel the world first, because college is much more expensive now offering student loans on help shot term.

Feb 10
Today I read a article about a man who spent a decade of his life in prison. Today he is now free, but to help boys who are going down the path he once took. He built a outdoor prison cell that took about 30 hours to build. For the whole month of Feb. he will stayb there family vring himm food and he has a coat and cover to keep warm. The police took a trouble juvinile to the cell after talking with the man the young boy said he will change.This was an bad man once that turn around for the better.

Feb 11
Ways of not getting audit by the Irs was offered on yahoo. Many peolpe get audit because of the numbers do not add up. If a tax paypaer has been caught doing something fraud it could also lead up to make you prove the deductions you file is accaurtely. The best thing to do is keep up with your recepits for three years so if you have to send in more paper work you can.

Feb.14
Today in class I read a chapter in my reading book about decover the person you are meant to be and where you are trying to go in life. Often times we are told by others what "they" think of us and if you aren't careful you could easily believe what others opioin or views of you is true. also we decussed to read more because it will only gain knowlgde such as you may do unrealistic things because of the heat of the moment but may come back and affect of us long or shortly after the desicion we made.

How the middle class became the underclass

With the unemployment rate still excessively high and the real estate market showing few signs of rebounding, the American middle class is still reeling from the effects of the Great Recession.
Meanwhile, as corporate profits come roaring back and the stock market charges ahead, the wealthiest people continue to eclipse their middle-class counterparts.
"I think it's a terrible dilemma, because what we're obviously heading toward is some kind of class warfare. www.yahoo.com
Feb.22
Today as I was reading over my car loan agreement with BB&T bank I notice m loan was origanlly 26,000 now almost 3 years later the balance is ony down 6,000 meaning I been paying ONLY intestest rates this is redicoulos. I read a book saying to always buy cars cash because the value always decerse. like a chapter in by rreading book stated that people do things out of the spite of a moment. I puarchase my car 3months after my dad died. I sometimes think I made that discsion because I was lonely, yet years later this was an mistake.

Feb 23.
I read on yahoo news that foreclosure homes is unhealthy. It is at its lowest in 13 years. Many with bad credit is unable to parchase the home cash while reatlors are getting loans from the bank to remodle the home to rent. Economics say it will take years for home to be worth the true value due to the recession. Jobs is improving daily so many can afford to keep there morgage.

Feb. 24
I'm reading a book called Unconditionally Single by Mary B. Morrision. It is about how women/men settle sometimes because of low self-esteem, lonely, are maybe just desparte to be in a relationship. Many even get married and do not know the person well enough to take vows. She gave an example on newledeys she met on a plane the husband ask the wife which sandwich she wanted tuna or fish? He should already knew what she perfer before tieing the knote when I get married I want to make sure I know my husband inside out.

Feb 25. Miss Cololordo's beauty queen is going through hard times last year her and her mother got a evicted notcie from the sheriff taht show up at the front door. Her dad died with cancer at a young age she explain that all her life she has not had it easy she is only 23. On top of that in month her job will shut down for good. She still has a warm heart and a true believer that god is not done with her this is just another test. She was an huge impiration to me because I can some what relate to her.
feb 28.
Today in class we dissuss how food companys make the food packages colorful to grab our attention. Sometimes we eat mindless eating or just because the ocassitonn. For instance like movie theater eating pop corn the bigger the buket the more we eat or somretime its good to sit to a person who is not a heavy eater because it will trigger our mind to eat less.

Mar 1.
We read over a chapter informing us about how portion in food can affect he BIM (body wieght mass). Though African Amercian house hold had the highest number from a survaye due to stress or emotinal eating mainly because of low income due to uneducated. Being little active plays a major role. Many enjoy watching T.V but snacking at the same time. In china the percentage is low because they watch their intake and move around more. Try sittong to a person who eat light next time at a reasturant or buy smaller cups and plates scientis sugessted.

Mar 2.
I read a yahoo passage about 25 ways you can waste your money such as buying things you really dont need such as name-brand food or household products. Also booking hotel rooms and flights threw a company like hot wire with lower rates for last min. booking. Also instead of puting money in checking accounts put on CD to get interset build up.

Mar 6.
Read the article about how apperence can determine your paycheck. In other words if you dress business and professionally on the job you can expect to get treated better and have more bucks guess the saying dress for suceess is the best and not the best earn less. Most office jobs perfer collar shirt and dress pants for women/ and men if a causl dress or skirt make sure past knees and a pair of panty holes perherably.
Mar. 7
We discussed in class about happiness come. Many said money, health, kids, married ect. Come to find out all is false. some people miss out on family time chasing money or spending long extra hours at the work office. Another cineria we brought up was that imates in prison we "think" is a BAD LIFE. But in reality they learn to adapt and adjust. All in all no matter where you are in life its about the state of mind you have to go along with the situation.
Mar 8.
Ways to improve reading and remember word to write down yhe word or think of someone or something that you can refer back to.
this will help in all other classes later on in collage. I actually tried this method and yep it works. Its call MAPPS.

Mar 9.
Many say to to own your business to work for yourself. It will allow you make your own scueldue. Have holidays off. You can even spend more time with family.
It is said many work for themself is more sucessfull. I started my own Mary kay business about 2 years ago and I enjoy it even though it does take plenty of self dispalne its well worth it.

Mar 21.
In class today how muliptive can be good/bad. For instance in stores they jack up prices the throw a sign up says 40% off which sounds like a sweet deal and we buy the item. Or like my professior say she let her son play basket ball for 30 min. and he have fun so he gets his exericse on at the same time. Or if a husband tell his wife he want a $30,000 car he first apporch her with a $60,000 so the car he really want his wife agrees to.
Mar.22
We discuss how Bill and John may attend the same school. Bill dad works coperate and John dad work for a factory company. Bill has a better chance makeing more mone and getting a better job. Even though it may seem unfair and very mush is its just how things work.
Mar.23
Nine-year-old Anaiah Rucker is being hailed as a hero after saving her sister from being hit by a truck last month. Anaiah told The Today Show's Ann Curry today that she didn't think twice before pushing her little sister out of the path of the vehicle as the pair crossed the street in Madison, Georgia to get to the school bus stop.
Anaiah took the hit, instead, and lost a leg and a kidney for her bravery.
"I love her more than anything," Anaiah told Channel 2's Tom Jones of her five-year-old-sister, Camry. Anaiah said it was raining and her sweatshirt hood was covering her eyes as she and her sister crossed the road. The girls' mother, Andrea Taylor, witnessed her older daughter's act of bravery from the porch of their home, where she watches the girls catch the bus each morning. -www.yahoo.com
Mar.24
WASHINGTON – Fewer people applied for unemployment benefits last week, adding to evidence that layoffs are slowing and employers may be stepping up hiring.
The number of people seeking benefits dropped by 5,000 to a seasonally adjusted 382,000 in the week ended March 19, the Labor Department said Thursday.-www.yahoo.com
Mar. 28
In class we discuss rather its right or wrong to quote others and not recongize the person who quoted ti first. I think its right. also we talked about college students go online copying others work. This is not good because you are not useing your own mind to think. taking credit from someone else thinking its not fair.
Mar 29.
How much can I afford to spend?
Experts say you will typically spend about a third of your income on financing your home. Before you start to look for your dream house, figure out just how much of that dream you can afford. Mortgage lenders look at your ability to repay the mortgage loan by reviewing:
  • Your credit history
  • Your monthly gross income
  • How much cash you can accumulate for a down payment, which is usually 10 percent to 20 percent of the sale price.
Mar 30

What is the best time to buy?
Because many buyers prefer to move in the spring or summer, the market starts to heat up as early as February. Families with children are anxious to buy so they can move during summer vacation, before the new school year begins. The market slows down in late summer before picking up again briefly in the fall. November and December have traditionally been slow months, although some astute buyers look for bargains during this period.
Mar 31
How long does it take to buy a house?
Buying a house can take from a few days to a few years. In most cases, the process will take several months of diligent effort.
How long should I look before buying a home?
You should look until you find the home that is right for you. This could take a week or a year depending on your personal needs and the state of the real estate market. Ideally, you would like to find a home after you have looked long enough to know what you like and what you do not like. You need time to educate yourself about the housing inventory.
April 1
How many times should I look at a house before I make an offer?
You will no doubt want to take a second or third look at a house that interests you. Your agent can arrange this; you should not call the sellers directly for access. But you should drive or walk by the house to get a better feel for the neighborhood. Return several times, at least once during rush hour, to see if the street is busy or congested. Drive a few blocks away from the house to see if the neighborhood holds up to your expectations. A map is a handy house-hunting aid.
Apr. 2
How do you find a good agent?
A good agent typically works full-time and has several years of experience at minimum. Buyers don't usually pay for your agent's services (in the form of a commission, or percentage of the sales price of the home). The seller usually pays all agents in a transaction from the sales proceeds. In many states, this means that your agent legally is acting as a subagent of the seller. But in some states, it's legal for an agent to represent the buyers exclusively in the transaction and be paid a commission by the sellers. You also can hire and pay for your own agent, known as buyer's brokers, whose legal obligation is exclusively to you. Yahoo.com
April 5
Yahoo.com
In an internal memo sent Monday, the bank said it will process checks starting with the smallest amounts first beginning July 25. Most banks process larger checks first, a practice consumer advocates say increases the potential for multiple overdraft violations on checking accounts.
Customers are being notified of the change in statements this week. The new check clearing method will only affect consumer checks. Citi does not process overdraft debit transactions or ATM withdrawals.
The change comes as overdraft programs continue to draw criticism from consumer watchdogs.
A new regulation that went into effect last year requires banks to obtain consent from customers before enrolling them in overdraft protection for debit transactions. But banks can still automatically enroll customers in overdraft protection for checks and automatic payments, a loophole that rankles consumer advocates.
Still, said Ruth Susswein of Consumer Action, Citi’s decision to do away with the high-to-low check clearing process was a step in the right direction.
Banks say the high-to-low check processing helps consumers because larger checks tend to be for mortgages and other high priority payments. But consumer advocates say the practice is a way for banks to rake in more overdraft charges. The fee is $34 per violation at Citi.
In the bank memo, consumer and commercial banking president Cece Stewart states that the change is a response to customer feedback.
In explaining how the change will work, she cites the example of a customer who has $100 in an account. If the customer writes checks for $90, $35 and $25, Citi would currently clear the $90 check first, meaning the two smaller checks would result in overdraft charges.
Under the new check clearing process, however, the smaller checks would be cleared first and the customer would only incur one overdraft penalty fee for the larger check.
IN GEORGIA
Wells Fargo, the No. 2 bank in Atlanta by deposits, said checks and certain automated check transactions will continue to clear by highest total first. Wells Fargo spokeswoman Jamie Dexter said these payments tend to be mortgage or car payments, and customers have indicated they prefer these are given priority,
but the bank is changing the way certain electronic transactions clear. Starting May 16, priority will be given to the time transactions occur or to the lowest amount for debit purchases, ATM withdrawals, bills paid online, certain account transfers and cash withdrawn or checks cashed through a teller.
Bank of America, the No. 3 bank in metro Atlanta by deposits, said it continues to add deposits and deduct transactions from checking accounts by the largest amounts first. “Often, a customer’s largest transactions are those most important to them,” BofA said in a statement, mentioning mortgages, insurance premiums and car loans.








































































































































































































































































































































































































































































































































































Electronic Filing Instructions for your 2010 Federal Tax Return

Important: Your taxes are not finished until all required steps are completed.

Declaration Control Number: 00-210062-66204-1 Accepted: 02/03/2011

Shonda L Pierce
750 Corder Rd., Apt. 91
Warner Robins, GA 31088

Page 1 of 1

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Balance
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Your federal tax return (Form 1040A) shows a refund due to you in the

Due/
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amount of $6,533.00. Applicable fees were deducted from your original

Refund
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refund amount of $6,533.00. Your refund is now $6,436.15. Because you

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chose to have your TurboTax fees deducted from your refund, you will

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receive e-mail from the University National Bank of Saint Paul, MN,

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which handles this transaction. The IRS estimates that you can expect

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your tax refund to be direct deposited into your account on or around

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02/18/2011. This is only an estimate. The account information you

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entered - Account Number: 3573870189 Routing Transit Number:

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061000227.
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_

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Where’s My
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Before you call the Internal Revenue Service with questions about

Refund?
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your refund, give them 8 to 14 days processing time from the date

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your return is accepted. If then you have not received your refund,

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or the amount is not what you expected, contact the Internal Revenue

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Service directly at 1-800-829-4477. You can also check www.irs.gov

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and select the "Where’s my refund?" link.
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No
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No signature form is required since you signed your return

Signature
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electronically.

Document
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Needed
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_

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What You
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Your Electronic Filing Instructions (this form)

Need to
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Printed copy of your federal return

Keep
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_

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2010
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Adjusted Gross Income $ 14,904.00

Federal
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Taxable Income $ 1,904.00

Tax
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Total Tax $ 0.00

Return
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Total Payments/Credits $ 6,533.00

Summary
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Amount to be Refunded $ 6,533.00

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Effective Tax Rate -20.46%
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Hi Shonda,
We just want to thank you for using TurboTax this year! It’s our goal to make
your taxes easy and accurate, year after year.
With TurboTax Deluxe:
Your Head Start On Next Year:
When you come back next year, taxes will be so easy! We’ll have all
your information saved and ready to transfer in to your new return.
We’ll ask you questions about what changed since we last talked, and
we’ll be ready to get you the credits and deductions you deserve, no
matter what life throws at you.
Here’s the final wrap up for your 2010 taxes:
Your federal refund is: $ 6,533.00
You qualified for these important credits:
- Child and Dependent Care Credit
- Child Tax Credit
- Earned Income Credit
Your Guarantee of Accuracy:
Breathe easy. The calculations on your return are backed with our
100% Accuracy Guarantee.
- We double checked your return for errors along the way.
- We helped with step-by-step guidance to get your answers on the right
IRS forms.
- We made sure you didn’t miss a deduction even if something in your life
changed, like a new job, new house - or more kids!
Also included:
- We e-filed your federal returns for free, so you could get your refund
in as few as 8 days.
- We provide the Audit Support Center free of charge, in the unlikely
event you get audited.
Many happy returns from TurboTax.

Consent to Use Your Tax Return Information

FDIY8001 10/12/10

Federal law requires this consent form be provided to you. Unless authorized by law, we cannot use, without your
consent, your tax return information for purposes other than the preparation and filing of your tax return.
You are not required to complete this form. If we obtain your signature on this form by conditioning our services on
your consent, your consent will not be valid. Your consent is valid for the amount of time that you specify. If you
do not specify the duration of your consent, your consent is valid for one year.
Before we continue, we need your permission to check your tax return to see if you are eligible for certain options
in our program. Specifically, we would like to check your age, whether you have a refund and the amount, your
state of residence, and whether you are a U.S. Resident.

The following statements apply:

I authorize Intuit, the maker of TurboTax to use the 2010 tax return information described above
to determine my eligibility to place all or a portion of my refund on a debit card.
Sign this agreement by entering your name:

Taxpayer’s First Name Taxpayer’s Last Name
Spouse’s First Name (if applicable) Spouse’s Last Name (if applicable)

Enter today’s date:

Date

If you believe your tax return information has been disclosed or used improperly in a manner unauthorized by law
or without your permission, you may contact the Treasury Inspector General for Tax Administration (TIGTA) by
telephone at 1-800-366-4484, or by email at
complaints@tigta.treas.gov.

CONSENT2

Shonda Pierce
01/15/2011

We Need Your Consent to Use Your Tax Return Information

FDIY1601 10/12/10

The IRS requires that we obtain your consent to use specific information in your tax return to determine if you can
use this payment method.

Protecting Your Privacy

Because you have selected this payment option, Intuit, the maker of TurboTax software, needs to check a few
items in your return to determine whether you can pay your fees from your refund. For example, you must reside
in the U.S. and your refund must be large enough to make the payment.
We’re asking your permission to perform these checks and providing some important information to you as
required by the IRS. To agree, simply enter your name(s) and the date in the boxes below after reading the
consent and select ’I Agree’.
I authorize Intuit, the maker of TurboTax, to use the information provided in this 2010 return to determine
whether a portion of the refund can be used to pay for tax preparation.
IRS regulations require the following statements:
’Federal law requires this consent form be provided to you. Unless authorized by law, we cannot use, without your
consent, your tax return information for purposes other than the preparation and filing of your tax return.
You are not required to complete this form. If we obtain your signature on this form by conditioning our services on
your consent, your consent will not be valid.Your consent is valid for the amount of time that you specify. If you do
not specify the duration of your consent, your consent is valid for one year.’

Taxpayer’s First Name Taxpayer’s Last Name
Spouse’s First Name (if applicable) Spouse’s Last Name (if applicable)

Please type the date below:

Date

If you believe your tax return information has been disclosed or used improperly in a manner unauthorized by law
or without your permission, you may contact the Treasury Inspector General for Tax Administration (TIGTA) by
telephone at 1-800-366-4484, or by email at
complaints@tigta.treas.gov.

CONSENT3

Shonda Pierce
01/25/2011

FDISCLOS SBIA1301 12/14/10

Finally, We Need Your Consent to Disclose Some Tax Information

Before we continue with processing your payment by transferring money from your tax
refund, we need to ask for your permission again, this time to forward certain of your
information to University National Bank of St. Paul, MN (’BANK’) and to Santa Barbara
Tax Processing Group (’SBTPG’), the administrator and servicer of your tax refund
transfer. To consent, type your first and last name and today’s date in the boxes below.

How This Protects Your Privacy

Because you are choosing to pay for your tax preparation with money from your refund,
Intuit, the maker of TurboTax software, needs to send a limited amount of personal
information from your tax return (such as your identifying information, deposit information
and refund amount) to BANK and SBTPG, the administrator and servicer of payment for
tax preparation services from your tax refund. Your information is sent via a secure SSL
encrypted transmission for the sole purpose of refund processing tax preparation service
payment. BANK and SBTPG are contractually obligated to protect the confidentiality of
your information.
We’re asking your permission to disclose that information and also providing some
important information to you as requested by the IRS. To agree, simply enter your
name(s) and date in the boxes below after reading this consent and select "I Agree".
I authorize Intuit, the maker of TurboTax, to disclose to BANK and SBTPG that
portion of my 2010 tax return information that is necessary to enable BANK and SBTPG
to process my refund and pay for my tax preparation.
IRS regulations require the following statements:
"Federal law requires this consent form be provided to you. Unless authorized by law, we
cannot disclose, without your consent, your tax return information to third parties for
purposes other than the preparation and filing of your tax return. If you consent to the
disclosure of your tax return information, Federal law may not protect your tax return
information from further use or distribution.
You are not required to complete this form. If we obtain your signature on this form by
conditioning our services on your consent, your consent will not be valid. If you agree to
the disclosure of your tax return information, your consent is valid for the amount of time
that you specify. If you do not specify the duration of your consent, your consent is valid
for one year."

Taxpayer First Name Taxpayer Last Name
Spouse First Name (if applicable) Spouse Last Name (if applicable)

Please type the date below:

Date

If you believe that your tax return information has been disclosed or used improperly in a
manner unauthorized by law or without your permission, you may contact the Treasury
Inspector General for Tax Administration (TIGTA) by telephone at 1-800-366-4484, or by
email at complaints@tigta.treas.gov.

Shonda Pierce
02/03/2011

FDIA1312 01/08/11
Department of the Treasury
'
Internal Revenue Service

Form
1040A U.S. Individual Income Tax Return (99) 2010 IRS Use Only '
Do not write or staple in this space.

Boxes
checked on
6a and 6b
No. of children
on 6c who:

?
lived
with you

?
did not
live with
you due to
divorce or
separation (see
instructions)
Dependents
on 6c not
entered above
Add numbers
on lines above

Exemptions 6 a Yourself.
If someone can claim you as a dependent, do not
check box 6a

b Spouse
c Dependents:
(1)
First name Last name

(2)
Dependent’s
social security
number

(3)
Dependent’s
relationship
to you

(4)
b
if
child under
age 17
qual for
child tax cr
(see instrs)
If more than six
dependents,
see instructions.

d
Total number of exemptions claimed

Income

7
Wages, salaries, tips, etc. Attach Form(s) W-2
7
8 a Taxable
interest. Attach Schedule B if required
8 a
b Tax-exempt
interest. Do not include on line 8a
8 b
9 a
Ordinary dividends. Attach Schedule B if required
9 a

Attach Form(s)
W-2 here. Also
attach Form(s)
1099-R if tax
was withheld. b
Qualified dividends (see instructions)
9 b
10
Capital gain distributions (see instructions)
10
11a
IRA distributions 11a 11b Taxable amount
11b
12a
Pensions and annuities 12a 12b Taxable amount
12b
13
Unemployment compensation and Alaska Permanent Fund dividends
(see instructions)
13
14a
Social security
benefits
14a 14b Taxable amount
14b

If you did not
get a W-2,
see instructions.
Enclose, but
do not attach,
any payment.
Also, please
use
Form 1040-V. 15 Add lines 7 through 14b (far right column). This is your
total income 15

Your first name and initial Last name OMB No. 1545-0074

Your social security number

Name,
Address,
and SSN

If a joint return, spouse’s first name and initial Last name
Spouse’s social security number

Home address (number and street). If you have a P.O. box, see instructions. Apartment no.

See separate
instructions

J

Make sure the SSN(s)
above and on line 6c
are correct.

City, town or post office. If you have a foreign address, see instructions. State ZIP code

Presidential
Election
Campaign
G

Filing 1
Single 4
Head of household (with qualifying person). (See instructions.)

status 2
Married filing jointly (even if only one had income) If the qualifying person is a child but not your dependent,

3
Married filing separately. Enter spouse’s SSN above and enter this child’s name here
full name here
5
Qualifying widow(er) with dependent child

Check only
one box.
(see instructions)
Check here if you, or your spouse if filing jointly, want $3 to go to this fund (see instructions)
You Spouse
16
Educator expenses (see instructions)
16
17
IRA deduction (see instructions)
17
18
Student loan interest deduction (see instructions)
18
19
Tuition and fees. Attach Form 8917
19

Adjusted
gross
income

20
Add lines 16 through 19. These are your
total adjustments 20
21
Subtract line 20 from line 15. This is your
adjusted gross income 21
BAA For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions.
Form 1040A
(2010)
Checking a box below will
not change your
tax or refund

Shonda L Pierce 258-67-8100
750 Corder Rd. 91
Warner Robins GA 31088
X
X
1
1
2
14,904.
14,904.
14,904.
Sar’Iah J Johnson 675-44-4711 Daughter X

Form
1040A (2010) Page
2
22
Enter the amount from line 21 (adjusted gross income)
22
23a
Check You
were born before January 2, 1946, Blind
if:
Spouse
was born before January 2, 1946, Blind

Total boxes
checked 23a

Tax, credits,
and
payments

b
If you are married filing separately and your spouse itemizes deductions,
see instructions and check here
23b
24
Enter your standard deduction (see instructions)
24
25
Subtract line 24 from line 22. If line 24 is more than line 22, enter -0-
25
26 Exemptions.
Multiply $3,650 by the number on line 6d
26
27
Subtract line 26 from line 25. If line 26 is more than line 25, enter -0-. This is your

taxable income 27
28 Tax,
including any alternative minimum tax
(see instructions)
28
29
Credit for child and dependent care expenses. Attach Form 2441
29
30
Credit for the elderly or the disabled. Attach Schedule R
30
31
Education credits from Form 8863, line 23
31
32
Retirement savings contributions credit. Attach Form 8880
32
33
Child tax credit (see instructions)
33
34
Add lines 29 through 33. These are your
total credits 34
35
Subtract line 34 from line 28. If line 34 is more than line 28, enter -0-
35
36
Advance earned income credit payments from Form(s) W-2, box 9
36
37
Add lines 35 and 36. This is your
total tax 37
38
Federal income tax withheld from Forms W-2 and 1099
38
39
2010 estimated tax payments and amount applied from
2009 return
39
40
Making work pay credit. Attach Schedule M
40
41a Earned income credit (EIC) 41a
b
Nontaxable combat pay election.
41b
42
Additional child tax credit. Attach Form 8812
42
43
American opportunity credit from Form 8863, line 14
43
44
Add lines 38, 39, 40, 41a, 42, and 43. These are your
total payments 44
45
If line 44 is more than line 37, subtract line 37 from line 44.

Refund
This is the amount you
overpaid 45
46a
Amount of line 45 you want refunded to you. If Form 8888 is attached, check here
46a

G
b
Routing
number
G c
Type: Checking Savings
Direct deposit?
See instructions
and fill in 46b,
46c, and 46d or
Form 8888.

G
d
Account
number

47
Amount of line 45 you want
applied to your 2011
estimated tax 47

Amount
you owe

48 Amount you owe.
Subtract line 44 from line 37. For details on how to pay,
see instructions
48
49
Estimated tax penalty (see instructions)
49

Do you want to allow another person to discuss this return with the IRS (see instructions)?
Yes. Complete the following.
No Third party
designee

Designee’s
name
G
Phone
no.
G

Personal
identification
number (PIN)
G

If you have
a qualifying
child, attach
Schedule EIC.

Sign
here

Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements, and to the best of my knowledge and belief, they
are true, correct, and accurately list all amounts and sources of income I received during the tax year. Declaration of preparer (other than the taxpayer) is based on all
information of which the preparer has any knowledge.
Your signature Date Your occupation Daytime phone number

Joint return?
See instructions.

Spouse’s signature. If a joint return,
both must sign. Date Spouse’s occupation
Keep a copy
for your records.

A

Print/Type preparer’s name Preparer’s signature Date Check
G if
PTIN
self-employed
Firm’s name
G

Paid
preparer
use only

Firm’s address
G Firm’s EIN
G

Phone no.

Form
1040A
(2010)

FDIA1312 01/08/11

Shonda L Pierce 258-67-8100
14,904.
5,700.
9,204.
7,300.
1,904.
191.
191.
0.
0.
191.
0.
0.
1,109.
400.
3,050.
1,000.
974.
6,533.
6,533.
6,533.
061000227 X
3573870189
X
Rental Sales Agent
Self-Prepared

1 (a)
Care provider’s name (b)
Address
(no., street, apt no., city, state, and ZIP code)

(c)
Identifying no.
(SSN or EIN)

(d)
Amount paid
(see instructions)
Did you receive
VVVVVV No VVVG
Complete only Part II below.

dependent care benefits?
VVVVVV Yes VVVG
Complete Part III on page 2 next.

Caution.
If the care was provided in your home, you may owe employment taxes. If you do, you cannot file Form 1040A. For details, see the
instructions for Form 1040, line 59, or Form 1040NR, line 58.

Part II Credit for Child and Dependent Care Expenses

2
Information about your qualifying person(s).
If you have more than two qualifying persons, see the instructions.

(a)
Qualifying person’s name (b)
Qualifying person’s social
security number

(c) Qualified
expenses
you
incurred and paid in
2010 for the person
First Last listed in column (a)

3
Add the amounts in column (c) of line 2. Do not
enter more than $3,000 for one qualifying person or $6,000
for two or more persons. If you completed Part III, enter the amount from line 31
3
4
Enter your earned income. See instructions
4
5
If married filing jointly, enter your spouse’s earned income (if your spouse was a student
or was disabled, see the instructions);
all others, enter the amount from line 4
5
6
Enter the smallest of line 3, 4, or 5
6
7
Enter the amount from Form 1040, line 38; Form 1040A, line 22; or Form
1040NR, line 37
7
8
Enter on line 8 the decimal amount shown below that applies to the amount on line 7

If line 7 is: If line 7 is:
Over
But not
over
Decimal
amount is Over
But not
over
Decimal
amount is

$0
' 15,000 .35 $29,000'
31,000 .27
15,000
' 17,000 .34 31,000'
33,000 .26
17,000
' 19,000 .33 33,000'
35,000 .25
19,000
' 21,000 .32 35,000'
37,000 .24
21,000
' 23,000 .31 37,000'
39,000 .23
23,000
' 25,000 .30 39,000'
41,000 .22
25,000
' 27,000 .29 41,000'
43,000 .21
27,000
' 29,000 .28 43,000'
No limit .20

8
X

FDIA3212 07/20/10
OMB No. 1545-0074

Form
2441 Child and Dependent Care Expenses

2010

Department of the Treasury
Internal Revenue Service
(99)

G
Attach to Form 1040, Form 1040A, or Form 1040NR.

G
See separate instructions.
Attachment
Sequence No.
21

Name(s) shown on return
Your social security number

Part I Persons or Organizations Who Provided the Care
' You must
complete this part.
(If you have more than two care providers, see the instructions.)

9
Multiply line 6 by the decimal amount on line 8. If you paid 2009 expenses in 2010, see the instructions
9
10
Tax liability limit. Enter the amount from the Credit Limit Worksheet
in the instructions
10
11 Credit for child and dependent care expenses.
Enter the smaller
of line 9 or line 10
here and on Form 1040, line 48; Form 1040A, line 29; or Form 1040NR, line 46
11
BAA For Paperwork Reduction Act Notice, see your tax return instructions.
Form 2441
(2010)

Shonda L Pierce 258-67-8100
776.
14,904.
14,904.
776.
14,904.
0.35
272.
191.
191.
Sar’Iah Johnson 675-44-4711 776.
Belles and Beaus 155 Smithville Church Rd.
Christian Learning Center Warne Robins GA 31088 20-0182916 775.64

Qualifying Child Information Child 1 Child 2 Child 3

1 Child’s name
First name Last name First name Last name First name Last name

If you have more than three qualifying
children, you only have to list three to get
the maximum credit

2 Child’s SSN

The child must have an SSN as defined in the
instructions for Form 1040A, lines 41a and
41b, or Form 1040, lines 64a and 64b, unless
the child was born and died in 2010. If your
child was born and died in 2010 and did not
have an SSN, enter ’Died’ on this line and
attach a copy of the child’s birth certificate,
death certificate, or hospital medical records.

3 Child’s year of birth
Year Year Year

If born after 1991 AND the child was
younger than you (or your spouse, if
filing jointly), skip lines 4a and 4b; go
to line 5.
If born after 1991 AND the child was
younger than you (or your spouse, if
filing jointly), skip lines 4a and 4b; go
to line 5.
If born after 1991 AND the child was
younger than you (or your spouse, if
filing jointly), skip lines 4a and 4b; go
to line 5.

4 a
Was the child under age 24 at the end of
2010, a student, and younger than you (or
your spouse, if filing jointly)?
Yes. No. Yes. No. Yes. No.

Go to line 5. Continue. Go to line 5. Continue. Go to line 5. Continue.

b
Was the child permanently and totally
disabled during any part of 2010?
Yes. No. Yes. No. Yes. No.

Continue.
The child
is not a
qualifying child.

Continue.
The child
is not a
qualifying child.

Continue.
The child
is not a
qualifying child.

5 Child’s relationship to you

(for example, son, daughter, grandchild,
niece, nephew, foster child, etc)

6 Number of months child lived with you in the
United States during 2010

?
If the child lived with you for more than
half of 2010 but less than 7 months,
enter ’7’.

?
If the child was born or died in 2010 and
your home was the child’s home for the
entire time he or she was alive during
2010, enter ’12’ months months months

Do not enter more than
12 months.
Do not enter more than
12 months.
Do not enter more than
12 months.

FDIA7401 11/04/10

SCHEDULE EIC
OMB No. 1545-0074

(Form 1040A or 1040)

Earned Income Credit

Qualifying Child Information
2010

Department of the Treasury
Internal Revenue Service
(99)

Complete and attach to Form 1040A or 1040
only if you have a qualifying child.
Attachment
Sequence No.
43

Name(s) shown on return
Your social security number

Before you begin:
?
See the instructions for Form 1040A, lines 41a and 41b, or Form 1040, lines 64a and
64b, to make sure that
(a) you can take the EIC and (b)
you have a qualifying child.

?
Be sure the child’s name on line 1 and social security number (SSN) on line 2 agree with the child’s social
security card. Otherwise, at the time we process your return, we may reduce or disallow your EIC. If the name or
SSN on the child’s social security card is not correct, call the Social Security Administration at 1-800-772-1213.

?
If you take the EIC even though you are not eligible, you may not be allowed to take the credit for up to 10 years. See the

CAUTION!
instructions for details.

?
It will take us longer to process your return and issue your refund if you do not fill in all lines that apply for each qualifying child.

BAA For Paperwork Reduction Act Notice, see your tax return instructions.
Schedule EIC
(Form 1040A or 1040) 2010

Shonda L Pierce 258-67-8100
Sar’Iah J Johnson
675-44-4711
2010
Daughter
12

Form
8862
OMB No. 1545-0074
(Rev. December 2009)

Information To Claim Earned Income Credit
After Disallowance

Department of the Treasury
Internal Revenue Service
G Attach to your tax return. G See separate instructions.
Attachment
Sequence No.
43A

Name(s) shown on return
Your social security number

Before you begin:
cSee your tax return instructions or Pub 596,
Earned Income Credit (EIC), for the year for which you are filing this
form to make sure you can take the earned income credit (EIC)
and
to find out who is a qualifying child.

c
If you have a qualifying child, complete Schedule EIC
before you fill in this form.

c
Do not file this form if you are taking the EIC without a qualifying child and
the only reason your EIC was
reduced or disallowed in the earlier year was because it was determined that a child listed on
Schedule EIC
was
not your qualifying child.

Part II Filers With a Qualifying Child or Children

Note. Child 1, Child 2,
and Child 3 are the same children you listed as Child 1, Child 2, and Child 3 on Schedule EIC
for the year shown
on line 1 above.

4
Enter the number of days
each child lived with you in the United States during the year shown on line 1 above:

a Child 1 b Child 2 c Child 3
Caution.
If you entered less than 183
for any child, you cannot take the EIC based on that child, unless the special rule for a child who
was born or died during the year shown on line 1 applies. See the instructions.

5
If your child was born or died during the year shown on line 1, enter the month and day the child was born and/or died. Otherwise, skip
this line.

a Child 1
G (1) Month and day of birth (MM/DD) (2)
Month and day of death (MM/DD)

b Child 2
G (1) Month and day of birth (MM/DD) (2)
Month and day of death (MM/DD)

c Child 3
G (1) Month and day of birth (MM/DD) (2)
Month and day of death (MM/DD)

6
Enter the address where you and the child lived together during the year shown on line 1. If you lived with the child at more than one
address during the year, attach a list of the addresses where you lived:

a Child 1
G
Number and street
City or town, state and ZIP code

b Child 2
G If same as shown for child 1, check this box. G
Otherwise, enter below:
Number and street
City or town, state and ZIP code

c Child 3
G If same as shown for child 1, check this box. G
Or if same as shown for child 2 (and this is different from address
shown for child 1), check this box.
G
Otherwise, enter below:
Number and street
City or town, state and ZIP code

BAA For Paperwork Reduction Act Notice, see separate instructions.
FDIA4201 01/19/10 Form 8862
(Rev. 12-2009)

Part I All Filers

1
Enter the year for which you are filing this form (for example, 2009)

2
If the only
reason your EIC was reduced or disallowed in the earlier year was because you incorrectly reported your
earned income or investment income, check ’Yes.’ Otherwise, check ’No’
Yes No
Caution.
If you checked ’Yes,’ stop. Do not
fill in the rest of this form. But you must attach it to your tax return to take
the EIC. If you checked ’No,’ continue.

3
Could you (or your spouse if filing jointly) be claimed as a qualifying child of another person for the year shown
on line 1?
Yes No
Caution.
If you checked ’Yes’, stop.
You cannot take the EIC. If you checked ’No,’ continue.

7
Did any other person (except your spouse, if filing jointly, and your dependents under age 19) live with child 1,
child 2, or child 3 for more than half the year shown on line 1?
Yes No

If ’Yes,’ enter that person’s name and relationship to the child below. If more than one other person lived with the child
for more than half the year, attach a list of each person’s name and relationship to the child:

a Other person living with child 1:
Name
Relationship to child 1

b Other person living with child 2: If same as shown for child 1, check this box.
G
Otherwise, enter below:
Name
Relationship to child 2

c Other person living with child 3: If same as shown for child 1, check this box.
G
Or if same as shown for child 2
(and this is different from the person living with child 1), check this box.
G

Otherwise, enter below:
Name
Relationship to child 3

Caution.
The IRS may ask you to provide additional information to verify your eligibility to claim the EIC.

Shonda L Pierce 258-67-8100
2010
X
X
365
04/14
X
750 Corder Rd. Apt. 91
Warner Robins, Ga. 31088

Part III Filers Without a Qualifying Child

8
Enter the number of days
during the year shown on line 1 that you lived in the United States

Caution.
If you entered less than 183, stop.
You cannot take the EIC. See the instructions.

9
If married filing a joint return, enter the number of days
during the year shown on line 1 that your spouse lived in the
United States

Caution.
If you entered less than 183, stop.
You cannot take the EIC. See the instructions.
Form
8862 (Rev 12-2009) Page
2

FDIA4201 01/19/10

Shonda L Pierce 258-67-8100

OMB No. 1545-0074

Form
8812 Additional Child Tax Credit

2010

Department of the Treasury
Internal Revenue Service
(99) Complete and attach to Form 1040, Form 1040A, or Form 1040NR.
Attachment
Sequence No.
47

Name(s) shown on return
Your social security number

Part I All Filers

1 1040 filers:
1040A filers:
1040NR filers:

Enter the amount from line 6 of your Child Tax Credit Worksheet (see the
Instructions for Form 1040, line 51).
Enter the amount from line 6 of your Child Tax Credit Worksheet (see the
Instructions for Form 1040A, line 33).
Enter the amount from line 6 of your Child Tax Credit Worksheet (see the
Instructions for Form 1040NR, line 48).
1

If you used Pub 972, enter the amount from line 8 of the worksheet on page 4 of the publication.

2
Enter the amount from Form 1040, line 51, Form 1040A, line 33, or Form 1040NR, line 48
2
3
Subtract line 2 from line 1. If zero, stop; you cannot take this credit
3
4 a
Earned income (see instructions)
4 a
b
Nontaxable combat pay (see instructions)
4 b
5
Is the amount on line 4a more than $3,000?

No.
Leave line 5 blank and enter -0- on line 6.

Yes.
Subtract $3,000 from the amount on line 4a. Enter the result
5
6
Multiply the amount on line 5 by 15% (.15) and enter the result
6
Next.
Do you have three or more qualifying children?

No.
If line 6 is zero, stop; you cannot take this credit. Otherwise, skip Part II and enter the smaller
of
line 3 or line 6 on line 13.

Yes.
If line 6 is equal to or more than line 3, skip Part II and enter the amount from line 3 on line 13.
Otherwise, go to line 7.

Part II Certain Filers Who Have Three or More Qualifying Children

7
Withheld social security and Medicare taxes from Form(s) W-2, boxes 4 and 6.
If married filing jointly, include your spouse’s amounts with yours. If you worked
for a railroad, see the instructions
7
8 1040 filers:
Enter the total of the amounts from Form 1040,
lines 27 and 57, plus any taxes that you identified using
code ’UT’ and entered on the dotted line next to line 60.
8
1040A filers:
Enter -0-.

1040NR filers:
Enter the total of the amounts from Form 1040NR, lines 27
and 55, plus any taxes that you identified using code ’UT’
and entered on the dotted line next to line 59.

9
Add lines 7 and 8
9
10 1040 filers:
Enter the total of the amounts from Form 1040, lines
64a and 69.

1040A filers:
Enter the total of the amount from Form 1040A, line 41a,
plus any excess social security and tier 1 RRTA taxes
withheld that you entered to the left of line 44
(see instructions).
10
1040NR filers:
Enter the amount from Form 1040NR, line 64.

11
Subtract line 10 from line 9. If zero or less, enter -0-
11
12
Enter the larger of line 6 or line 11
12
Next,
enter the smaller
of line 3 or line 12 on line 13.

Part III Additional Child Tax Credit

13 This is your additional child tax credit 13

Enter this amount on
Form 1040, line 65,
Form 1040A, line 42, or
Form 1040NR, line 62.

BAA For Paperwork Reduction Act Notice, see your tax return instructions.
FDIA3001 07/08/10 Form 8812
(2010)

Shonda L Pierce 258-67-8100
1,000.
0.
1,000.
14,904.
X 11,904.
1,786.
X
1,000.

OMB No. 1545-0074

Form
8863 Education Credits (American Opportunity and
Lifetime Learning Credits) 2010

Department of the Treasury
Internal Revenue Service
(99)

G
See separate instructions to find out if you are eligible to take the credits.

G
Attach to Form 1040 or Form 1040A.
Attachment
Sequence No.
50

Name(s) shown on return
Your social security number

CAUTION! You cannot
take both an education credit and the tuition and fees deduction (see Form 8917) for the same student
for the
same year.

Part II Lifetime Learning Credit.

Caution:
You cannot take the American opportunity credit and the lifetime learning credit for the same student in the same year.

3
(a)
Student’s name (as shown on page 1 of your tax return)

(b)
Student’s social
security number (as
shown on page 1 of
your tax return)

(c)
Qualified
expenses
(see instructions)
First name Last name

4
Add the amounts on line 3, column (c), and enter the total
4
5
Enter the smaller of line 4 or $10,000
5
6 Tentative lifetime learning credit.
Multiply line 5 by 20% (.20). If you have an entry on line 2, go to Part III;
otherwise go to Part IV
6
BAA For Paperwork Reduction Act Notice, see your tax return instructions.
FDIA3601 12/31/10 Form 8863
(2010)

Part I American Opportunity Credit

Caution:
You cannot take the American opportunity credit for more than 4 tax years for the same student.

1 (a)
Student’s name
(as shown on page 1
of your tax return)

(b)
Student’s
social security
number (as shown
on page 1 of
your tax return)

(c)
Qualified
expenses (see
instructions).
Do
not
enter more
than $4,000 for
each student.

(d)
Subtract $2,000
from the amount in
column (c). If zero
or less, enter -0-

(e)
Multiply the
amount in column
(d) by 25% (.25)

(f)
If column (d) is
zero, enter the
amount from
column (c). Otherwise,
add $2,000 to
the amount in
column (e).
First name
Last name

2 Tentative American opportunity credit.
Add the amounts on line 1, column (f). If you are taking the lifetime
learning credit for a different student, go to Part II; otherwise, go to Part III
2

Shonda L Pierce 258-67-8100
2,436.
Shonda L
Pierce 258-67-8100 3,742. 1,742. 436. 2,436.

Part III Refundable American Opportunity Credit

7
Enter the amount from line 2
7
8
Enter: $180,000 if married filing jointly; $90,000 if single, head of household,
or qualifying widow(er)
8
9
Enter the amount from Form 1040, line 38,* or Form 1040A, line 22
9
10
Subtract line 9 from line 8. If zero or less, stop;
you cannot take any
education credit
10
11
Enter: $20,000 if married filing jointly; $10,000 if single, head of household,
or qualifying widow(er)
11
12
If line 10 is:

?
Equal to or more than line 11, enter 1.000 on line 12

?
Less than line 11, divide line 10 by line 11. Enter the result as a decimal (rounded
to at least three places)
12
13
Multiply line 7 by line 12. Caution: If you were under age 24 at the end of the year and
meet the
conditions in the instructions, you
cannot
take the refundable American opportunity credit. Skip
line 14, enter the amount from line 13 on line 15, and check this box
13
14 Refundable American opportunity credit.
Multiply line 13 by 40% (.40). Enter the amount here and on Form
1040, line 66, or Form 1040A, line 43. Then go to line 15 below
14

Form
8863 (2010) Page
2

Part IV Nonrefundable Education Credits

15
Subtract line 14 from line 13
15
16
Enter the amount from line 6, if any. If you have no entry on line 6, skip lines 17 through 22, and enter the
amount from line 15 on line 6 of the Credit Limit Worksheet (see instructions)
16
17
Enter: $120,000 if married filing jointly; $60,000 if single, head of household,
or qualifying widow(er)
17
18
Enter the amount from Form 1040, line 38,* or Form 1040A, line 22
18
19
Subtract line 18 from line 17. If zero or less, skip lines 20 and 21, and enter
zero on line 22
19
20
Enter: $20,000 if married filing jointly; $10,000 if single, head of household,
or qualifying widow(er)
20
21
If line 19 is:

?
Equal to or more than line 20, enter 1.000 on line 21 and go to line 22

?
Less than line 20, divide line 19 by line 20. Enter the result as a decimal (rounded to at least three
places)
21
22
Multiply line 16 by line 21. Enter here and on line 1 of the Credit Limit Worksheet (see instructions)
22
23 Nonrefundable education credits.
Enter the amount from line 11 of the Credit Limit Worksheet (see
instructions) here and on Form 1040, line 49, or Form 1040A, line 31
23

* If you are filing Form 2555, 2555-EZ, or 4563, or you are excluding income from Puerto Rico, see Pub 970 for the amount to enter.

Form
8863
(2010)

FDIA3601 12/31/10

Shonda L Pierce 258-67-8100
2,436.
90,000.
14,904.
75,096.
10,000.
1.000
2,436.
974.
1,462.
0.

SCHEDULE M
OMB No. 1545-0074

(Form 1040A or 1040) Making Work Pay Credit 2010

Department of the Treasury
Internal Revenue Service
(99)

G
Attach to Form 1040A or 1040. G See separate instructions.
Attachment
Sequence No.
166

Name(s) shown on return
Your social security number

Important:
Check the ’No’
box on line 1a and see the instructions if:

(a)
You have a net loss from a business,

(b)
You received a taxable scholarship or fellowship grant not reported on a Form W-2,

(c)
Your wages include pay for work performed while an inmate in a penal institution,

(d)
You received a pension or annuity from a nonqualified deferred compensation plan or a nongovernmental
section 457 plan, or

(e)
You are filing Form 2555 or 2555-EZ.

7
Is the amount on line 5 more than the amount on line 6?

No.
Skip line 8. Enter the amount from line 4 on line 9 below.

Yes.
Subtract line 6 from line 5
7
8
Multiply line 7 by 2% (.02)
8
9
Subtract line 8 from line 4. If zero or less, enter -0-
9
10
Did you (or your spouse, if filing jointly) receive an economic recovery payment in 2010
? You may have
received this payment in 2010 if you did not receive an economic recovery payment in 2009 but you received
social security benefits, supplemental security income, railroad retirement benefits, or veterans disability
compensation or pension benefits in November 2008, December 2008, or January 2009 (see instructions).

No.
Enter -0- on line 10 and go to line 11.

Yes.
Enter the total of the payments you (and your spouse, if filing jointly) received in
2010.

Do not enter more than $250 ($500 if married filing jointly)
10
11 Making work pay credit.
Subtract line 10 from line 9. If zero or less, enter -0-. Enter the result here and on
Form 1040, line 63; or Form 1040A, line 40
11

*If you are filing Form 2555, 2555-EZ, or 4563 or you are excluding income from Puerto Rico, see instructions.

BAA For Paperwork Reduction Act Notice, see your tax return instructions.
Schedule M
(Form 1040A or 1040) 2010

FDIA8501 09/20/10

1 a
Do you (and your spouse if filing jointly) have 2010 wages of more than $6,451 ($12,903 if married filing jointly)?

Yes.
Skip lines 1a through 3. Enter $400 ($800 if married filing jointly) on line 4 and go to line 5.

No.
Enter your earned income (see instructions)
1 a
b
Nontaxable combat pay included on line 1a
(see instructions)
1 b
2
Multiply line 1a by 6.2% (.062)
2
3
Enter $400 ($800 if married filing jointly)
3
4
Enter the smaller of line 2 or line 3 (unless you checked ’Yes’ on line 1a)
4
5
Enter the amount from Form 1040, line 38*, or Form 1040A, line 22
5
6
Enter $75,000 ($150,000 if married filing jointly)
6
Caution:
To take the making work pay credit, you must include your social security number (if filing a joint return, the number of either you or
your spouse) on your tax return. A social security number does not include an identification number issued by the IRS. Only the
Social Security Administration issues social security numbers.

Caution:
You cannot take the making work pay credit if you can be claimed as someone else’s dependent or if you are a nonresident alien.

Shonda L Pierce 258-67-8100
X
400.
14,904.
75,000.
X
400.
X
0.
400.

Form
1098-T Tuition Statement 2010

G
Keep for your records

Taxpayer’s name Social Security No.

Identify Student (Required):
A
If student is

Double-click
to link this 1098-T to the applicable
Taxpayer or Spouse
Student Information Worksheet

B
If student is

Double-click
to link this 1098-T to the applicable
Dependent Student
Information Worksheet

Filer’s name
1
Payments received for qualified
tuition and related expenses
$

Street address
City State Zip Code
2
Amounts billed for qualified tuition
and related expenses
$

Telephone no. Ext:
3
If this box is checked, your educational institution
has changed its reporting method for 2010

Filer’s
Federal Student’s 4 Adjustments made for a 5
Scholarships or grants
identification number Social Security Number. prior year

$ $

Student’s name
6 Adjustments to 7
Check this box if the amount
scholarships or grants in box 1 or 2 includes
Street address Apt. No. for a prior year amounts for an
academic period
City State Zip Code beginning January -

$
March 2011
Service Provider/ Acct No
8 Check if at least 9 Check if a graduate 10
Ins. contract reimb./refund
half-time student student
$

Reconciliation of Box 2, Amounts Billed for Qualified Tuition and Related Expenses

A
Enter portion of box 2 amount not
paid during 2010

B
Enter portion of box 2 amount actually paid during 2010

Shonda L Pierce 258-67-8100
Shonda
Shonda
Sar’Iah
Middle Georgia College
1100 Second Street SE
Cochran GA 31014 3,042.
58-6002057 258-67-8100
Shonda
750 Corder Rd. 91
Warner Robins GA 31088
0.
3,042.

Tax Payments Worksheet 2010

G
Keep for your records

Name(s) Shown on Return Social Security Number

Estimated Tax Payments for 2010
(If more than 4 payments for any state or locality, see Tax Help)

Federal State Local
Date Amount Date Amount ID Date Amount ID
1
2
3
4
5
Tot Estimated
Payments
Tax Payments Other Than Withholding Federal State ID Local ID

(If multiple states, see Tax Help)

6
Overpayments applied to 2010

7
Credited by estates and trusts

8 Totals
Lines 1 through 7

9
2010 extensions

Taxes Withheld From: Federal State Local
10
Forms W-2

11
Forms W-2G

12
Forms 1099-R

13
Forms 1099-MISC and 1099-G

14
Schedules K-1

15
Forms 1099-INT, DIV and OID

16
Social Security and Railroad Benefits

17
Form 1099-B St Loc

18 a
Other withholding St Loc

b
Other withholding St Loc

c
Other withholding St Loc

19 Total Withholding
Lines 10 through 18c

20 Total Tax Payments for 2010

Prior Year Taxes Paid In 2010 State ID Local ID

(If multiple states or localities, see Tax Help)

21
Tax paid with 2009 extensions

22
2009 estimated tax paid after 12/31/09

23
Balance due paid with 2009 return

24
Other (amended returns, installment payments, etc)

Shonda L Pierce 258-67-8100
04/15/10 04/15/10 04/15/10
06/15/10 06/15/10 06/15/10
09/15/10 09/15/10 09/15/10
01/18/11 01/18/11 01/18/11
1,109. 383.
1,109. 383.
1,109. 383.

Education Tuition and Fees Summary 2010

G
Keep for your records

Name(s) Shown on Return Your Social Security No.

Part I - Qualified Education Expense Summary

(a) (b) (c) (d) (e)

Student’s name Qualified Qualified Elected Elected
First Name MI Education for: Credit or Credit or
Last Name Suffix Expenses Deduction Deduction
Social Security Number if if
Yes No
manual automatic

Amer Opp Cr
Lifetime Cr
Tuition Ded
Amer Opp Cr
Lifetime Cr
Tuition Ded
Amer Opp Cr
Lifetime Cr
Tuition Ded
Total qualified expenses Amer Opp Cr
Lifetime Cr
Tuition Ded

Part II - Optimize Education Expenses for the Lowest Tax

Shonda L Pierce 258-67-8100
3,742.
3,742.
3,742.
Shonda L 3,742. X X
Pierce 3,742. X
258-67-8100 3,742. X
3,742.

1 Launch OPTIMIZER
- Check to launch Automatic Education Expense Optimizer now

Automatic

2 Automatic
- Check to use the Credit choices calculated in Part I, column (e) above
or

3 Manual
- Check to use the Credit choices you entered in Part I, column (d) above

X

Part III - Summary of Net Tax, Deduction, and Credits

Net Tax Liability based on the Credit combination selected in Part II
1 Total tax 1
2
Making work pay and government retiree credit.
2
3
Earned income credit (EIC)
3
4
Additional child tax credit.
4
5
First-time homebuyer credit from Form 5405
5
6
Credit for federal tax paid on fuels from Form 4136
6
7
Refundable credit from Form 8801
7
8
Health Coverage Tax Credit from Form 8885
8
9 Net tax Liability without carryforwards 9
Credit Carryforwards
10 a
General Business Credit
10a
b
Mortgage interest credit
b
c
Foreign tax credit
c
d
Residential Energy Credit
d
e
Other carryover
e
f
Other carryover
f

Total Carryovers
10
11 Net tax liability with carryforwards 11
Tuition and Fees Deduction Summary
12
Total 2010 tuition and fees paid for purposes of deduction
12
13
Modified adjusted gross income
13
14
Maximum deduction allowed
14
15
Allowable Tuition and Fees Deduction (lesser of line 12 or line 14)
15
American Opportunity, Lifetime Learning Credits Summary
16
Tentative American Opportunity Credit
16
17
Tentative Lifetime Learning Credit
17
18
Total Education Credits (after limitations)
18

Shonda L Pierce 258-67-8100
0.
400.
3,050.
1,000.
0.
0.
0.
2,436.
974.

Federal Carryover Worksheet 2010

G
Keep for your records

Name(s) Shown on Return Social Security Number

2009 State and Local Income Tax Information
(See Tax Help)

(a) (b) (c) (d) (e) (f) (g)
State or Paid With Estimates Pd Total With- Paid With Total Over- Applied
Local ID Extension After 12/31 held/Pmts Return payment Amount
Totals
Other Tax and Income Information 2009 2010
1
Filing status
1
2
Number of exemptions for blind or over 65 (0 - 4)
2
3
Itemized deductions after limitation
3
4
Check box if required to itemize deductions
4
5
Adjusted gross income
5
6
Tax liability for Form 2210 or Form 2210-F
6
7
Alternative minimum tax
7
8
Federal overpayment applied to next year estimated tax
8
QuickZoom to the IRA Information Worksheet for IRA information

Excess Contributions 2009 2010
9 a
Taxpayer’s excess Archer MSA contributions as of 12/31
9 a
b
Spouse’s excess Archer MSA contributions as of 12/31
b
10 a
Taxpayer’s excess Coverdell ESA contributions as of 12/31
10 a
b
Spouse’s excess Coverdell ESA contributions as of 12/31
b
11 a
Taxpayer’s excess HSA contributions as of 12/31
11 a
b
Spouse’s excess HSA contributions as of 12/31
b
Loss and Expense Carryovers 2009 2010
12 a
Short-term capital loss
12 a
b
AMT Short-term capital loss
b
13 a
Long-term capital loss
13 a
b
AMT Long-term capital loss
b
14 a
Net operating loss available to carry forward
14 a
b
AMT Net operating loss available to carry forward
b
15 a
Investment interest expense disallowed
15 a
b
AMT Investment interest expense disallowed
b
16
Nonrecaptured net Section 1231 losses from: a 2010
16 a
b
2009
b
c
2008
c
d
2007
d
e
2006
e
f
2005
f

Shonda L Pierce 258-67-8100
2,596. 1,991.
1 Single 1 Single
2,596. 383.
18,268. 14,904.
0. 0.
GA 2,596. 1,991.

Federal Carryover Worksheet page 3 2010

Charitable Contribution Carryovers
26 2009
Carryover of
Other Property Capital Gain

charitable contributions
from:
(a) 50% (b) 30% (c) 30% (d)
20%

a
2009

b
2008

c
2007

d
2006

e
2005

27 2010
Carryover of
Other Property Capital Gain

charitable contributions
from:
(a) 50% (b) 30% (c) 30% (d)
20%

a
2010

b
2009

c
2008

d
2007

e
2006

28
Amount overpaid less earned income credit

2009 State Capital Loss Carryovers
(For users not
transferring from the prior year)

State Short-term AMT Short-term Long-term AMT Long-term Capital Loss AMT Capital Loss
ID Capital Loss Capital Loss Capital Loss Capital Loss (combined) (combined)
for State for State for State for State for State for State

Shonda L Pierce 258-67-8100
3,355.

University National Bank Refund Processing Agreement (’Agreement’)

Name:
Social Security No.:
This Agreement contains important terms, conditions and disclosures about the processing of your refund by University National Bank of Saint
Paul, MN, (BANK). Read this Agreement carefully before accepting its terms and conditions, and print a copy and/or retain this information
electronically for future reference. As used in this Agreement, the words ’you’ and ’your’ refer to the applicant or both the applicant and joint
applicant if the 2010 federal income tax return is a joint return (individually and collectively, ’Applicant’). The words ’we,’ ’us’ and ’our’ refer
to BANK.
1.
NOTICE: No Requirement To Have BANK Process Your Refund In Order To File Electronically.

YOU UNDERSTAND THAT BANK CHARGES A REFUND PROCESSING SERVICE FEE OF $ TO ESTABLISH A TEMPORARY ACCOUNT
TO RECEIVE YOUR TAX REFUND, TO DEDUCT YOUR TURBOTAX FEES FROM THAT ACCOUNT, AND TO FORWARD FUNDS TO YOU. THE
REFUND PROCESSING SERVICE FEE IS NOT A LOAN; IT IS DUE TO BANK WHETHER OR NOT THE REFUND TRANSFER OCCURS. YOU
CAN AVOID THIS FEE AND NOT USE BANK’S REFUND PROCESSING SERVICE BY, INSTEAD, PAYING THE APPLICABLE TURBOTAX FEES
TO INTUIT BY CREDIT OR DEBIT CARD AT THE TIME YOU FILE YOUR 2010 FEDERAL INCOME TAX RETURN AND ELECTING TO HAVE
YOUR REFUND DIRECTLY DEPOSITED IN YOUR OWN BANK ACCOUNT OR MAILED TO YOU. IF YOU DO USE THE REFUND-PROCESSING
SERVICE, YOU CAN EXPECT TO RECEIVE THE PROCEEDS FROM YOUR TAX REFUND WITHIN 8 TO 15 DAYS FROM WHEN THE IRS
ACCEPTS YOUR RETURN. IF YOU DO NOT USE THE REFUND-PROCESSING SERVICE, BUT DO FILE YOUR TAX RETURN
ELECTRONICALLY, AND HAVE YOUR TAX REFUND DIRECTLY DEPOSITED INTO A BANK ACCOUNT, YOU CAN EXPECT TO RECEIVE
YOUR REFUND WITHIN 8 TO 15 DAYS FROM WHEN THE IRS ACCEPTS YOUR RETURN. IF YOU ELECT TO RECEIVE YOUR TAX REFUND
THROUGH THE MAIL, YOU CAN EXPECT TO RECEIVE YOUR REFUND IN 3 TO 4 WEEKS FROM WHEN THE IRS ACCEPTS YOUR RETURN.
THE COST OF PREPARING YOUR TAX RETURN IS NOT ANY MORE OR LESS IF YOU PURCHASE THE REFUND PROCESSING SERVICE.
2.
Authorization to Release Personal Information.
You authorize the Internal Revenue Service ("IRS") to disclose any information to BANK
related to the funding of your 2010 tax refund. You also authorize Intuit, as the transmitter of your electronically filed tax return, to disclose
your tax return and contact information to BANK for use in connection with the refund processing services being provided pursuant to this
Agreement and BANK to share your information with Intuit. Neither Intuit nor BANK will disclose or use your tax return information for any other
purpose, except as permitted by law. BANK will not use your tax information or contact information for any marketing purpose. For more
information concerning our privacy policy please see the disclosures at the end of this Agreement describing how BANK may use or share your
personal information.
3.
Summary of Terms

Expected Federal Refund
$

Less BANK Refund Processing Service Fee
$

Less TurboTax Fees
$

Less Additional Products and Services Purchased
$

Expected Proceeds*
$

*These charges are itemized. This is only an estimate. The amount will be reduced by any applicable sales taxes, and if applicable, a ten dollar
($10) BANK handling fee as set forth in paragraphs 4 and 7 below.
4.
Temporary Deposit Account Authorization.
You hereby authorize BANK to establish a temporary deposit account (’Deposit Account’) for
the purpose of receiving your tax year 2010 federal income tax refund from the IRS. BANK must receive an acknowledgment from the IRS
that your return has been electronically filed and accepted for processing before the Deposit Account can be opened. You authorize BANK
to deduct from your Deposit Account the following amounts: (i) the BANK refund processing service fee; (ii) the fees and charges related to
the preparation, processing and transmission of your tax return (Turbo Tax Fees); and, (iii) amounts to pay for additional products and services
purchased plus applicable taxes. You also authorize BANK to deduct ten dollars ($10) as a BANK handling fee, from your Deposit Account in
the event that your deposit is returned or you provide incorrect bank account or routing information, as set forth in the Note below paragraph 7
below.You authorize BANK to disburse the balance of the Deposit Account to you after making all authorized deductions or payments.
5.
Acknowledgments.
(a) You understand that: (i) BANK cannot guarantee the amount of your tax year 2010 federal income tax refund or
the date it will be issued, and (ii) BANK is not affiliated with the transmitter of the tax return (Intuit) and does not warrant the accuracy of the
software used to prepare the tax return. (b) You agree that Intuit is not acting as your agent and is not under any fiduciary duty with respect
to the processing of your refund by BANK.
6.
Truth in Savings Disclosure.
The Deposit Account is being opened for the purpose of receiving your (both spouses if this is a jointly filed
return) tax year 2010 federal tax refund. We will charge the fees set forth in Section 3 for the Account. No other deposits may be made to the
Deposit Account. No withdrawals will be allowed from the Deposit Account except as provided in Section 4. No interest is payable on the
deposit; thus, the annual percentage yield and interest rate are 0%. The Deposit Account will be closed after all authorized deductions have
been made and any remaining balance has been disbursed to you. Questions or concerns about the Deposit Account should be directed to:
University National Bank, P.O. Box 261059, San Diego, CA 92126, or via the Internet at http://cisc.sbtpg.com.

RTAPP SCB_1133_12-20-10 SBIA0912 01/05/11

Shonda L Pierce
258-67-8100

29.95

6,533.00
29.95
66.90
6,436.15

8.
Federal Electronic Fund Transfer Act Disclosures:
The Federal Electronic Fund Transfer Act provides you with certain rights and obligations
regarding the Federal and state income tax refund that will be electronically deposited into your Account established at BANK for that purpose.
If you believe that there is an error or if you have a question about your Account, write to University National Bank, P.O. Box 261059, San
Diego, California 92126 or telephone (800) 717-7228 and provide BANK with your name, a description or explanation of the error and the dollar
amount of the suspected error. BANK will advise you of the results of its investigation within 10 business days.
9.
Compensation.
In addition to any fees paid directly by you to Intuit, BANK will pay a portion of BANK’s refund processing fee to Intuit in
consideration of Intuit’s provision of various programming, testing, data processing, transmission, systems maintenance, status reporting and
other software, technical and communications services.
10.
Governing Law.
The enforcement and interpretation of this Agreement and the transactions contemplated herein shall be governed by the
laws of the United States, including the Electronic Signatures in Global and National Commerce Act, and, to the extent state law applies, the
substantive law of Minnesota.
11.
Arbitration Provision.
You agree that any and all disputes which in any way arise out of or relate to this agreement, shall be resolved solely
by binding arbitration before the American Arbitration Association (’AAA’) before a single arbitrator in an arbitration commenced as close as
possible to where you reside. Judgment on the award rendered by the arbitrator may be entered in any court having jurisdiction thereof. Each
party to any such arbitration shall bear its own separate costs and expenses of the arbitration and shall share equally in the charges of the
AAA, including the fee of the arbitrator. However, if you are unable to pay any fee of the AAA or the arbitrator, we agree to pay those fee
for you.
12.
USA Patriot Act Disclosure.
To help the government fight the funding of terrorism and money laundering activities, Federal law requires all
financial institutions to obtain, verify, and record information that identifies each person who opens an account. What this means for you: When
we open an Account for you for the purpose of receiving your IRS refund deposit or if you apply for one of our products, we will ask for your
name, address, date of birth, and other information that will allow us to identify you. We may also ask for your driver’s license information or
information from other identifying documents of yours.

RTAPP SCB_1133_12-20-10 SBIA0912 01/05/11

b) Direct Deposit to Checking or Savings Account: If you choose this option, the balance of your Deposit Account will be disbursed to you
electronically by ACH Direct Deposit to your personal bank account designated below. If a joint return is filed, the bank account may
be a joint account or the individual account of either spouse.

DIRECT DEPOSIT ACCOUNT TYPE:
Checking Savings

RTN #: ACCOUNT #:
Note: To ensure that there are no delays in receiving your refund, please contact your financial institution to confirm that you are using the
correct RTN (routing) and account number.
If you or your representative enter your personal bank account information incorrectly and your
deposit is returned to BANK, the refund balance minus a $10 BANK handling fee will be disbursed to you via a cashier’s check mailed to the
address on your tax return. If the direct deposit is not returned to BANK, you will be responsible for the loss.
7.
Disbursement Method:
You agree that the disbursement method selected below will be used by BANK to disburse funds to you.
a) Direct Deposit to Prepaid Debit Card: If you choose this option, you authorize BANK to transfer the balance of your Deposit Account
to the financial institution that supports your prepaid debit card, so that the financial institution may deposit the balance of your
refund, as directed by you, on the respective prepaid debit card you have selected.
Additional fees will be charged for the use of the
card. Please review the cardholder agreement associated with the use of your prepaid debit card provided by the participating
financial institution to learn of other fees, charges, terms and conditions that will apply. BANK will not be responsible for your
funds once they have been deposited with the respective financial institution.
YOUR AGREEMENT

By selecting the button in TurboTax: (i) You authorize BANK to receive your 2010 federal tax refund from the IRS and to make
the deductions from your refund described in the Agreement, (ii) You agree to receive all Communications electronically in accordance with the
’Consent to Conduct Business Electronically’ section of the License Agreement for Tax Year 2010 TurboTax(R) Software and Services, as the
term ’Communications’ is defined therein, (iii) You consent to the release of your 2010 refund deposit information and application information
as described in Section 2 of this Agreement; and (iv) You acknowledge that you have reviewed, and agree to be bound by, the Agreement’s
terms and conditions. You understand that, if you change your tax year 2010 federal tax return information in a way that affects the amount of
your refund, you must review and accept the Agreement again. If this is a joint return, selecting indicates that both spouses
agree to be bound by the terms and conditions of the Agreement.

Shonda L Pierce 258-67-8100
X
X
061000227 3573870189

’I Agree’
’I Agree’

Rev 01/2011

FACTS
What does University National Bank do with your Personal Information?

Why?
Financial Companies choose how they share your personal information. Federal law gives
consumers the right to limit some but not all sharing. Federal law also requires us to tell you
how we collect, share, and protect your personal information. Please read this notice carefully
to understand what we do.

What?
The types of personal information we collect and share depend on the product or service you
have with us. This can include:

?
Social Security Number

?
Income

?
Account balances

?
Payment history

?
Transaction history

How?
All Financial Companies need to share customers’ personal information to run their everyday
business. In the section below, we list the reasons Financial Companies can share their
customers’ personal information; the reasons University National Bank chooses to share and
whether you can limit the sharing.

Reasons we can share your personal information Does University National
Bank share?
Can you limit this
sharing?
For our everyday business purposes
'

such as to process your transaction, maintain
your account(s), respond to court orders and legal
investigations, or report to credit bureaus.
Yes No

For our marketing purposes
'

to offer our products and services to you. No We don’t share

For joint marketing with other financial companies.
No We don’t share

For our affiliates’ everyday business purposes
'

information about your transactions and experiences. No We don’t share

For our affiliates’ everyday business purposes
'

information about your creditworthiness. No We don’t share

For our affiliates to market to you.
No We don’t share

For nonaffiliates to market to you.
No We don’t share

Questions?
Toll Free: 800-717-7228.

SBIA0912 01/05/11

Shonda L Pierce 258-67-8100

Page 2

Who we are

Who is providing this notice?
University National Bank

What we do

How does University National Bank
protect my personal information?

To protect your personal information from unauthorized access
and use, we use security measures that comply with federal law.
These measures include computer safeguards and secured files
and buildings. Your information is accessible only to employees
who need the information in order to process your product
request, answer your questions or determine the types of additional
products or services that we think may interest you. We train our
employees on their responsibility to maintain the privacy for your
personal information.

How does University National Bank
collect my personal information?

We collect your personal information about you when you apply for a
tax related product. This includes information in your application and
your tax return in each year that you applied for a tax-related bank
product, such as your name, address, social security number, income,
deductions, refund and the like. We also collect information about
your transactions with us, other lenders, tax preparers and similar
providers, such as payment histories, balances due, and tax
information. We may also collect information concerning your credit
history from a consumer reporting agency.

Why can’t I limit all sharing?
Federal law gives you the right to limit only:

?
Sharing for affiliates’ everyday business purposes '
information
about your creditworthiness,

?
Affiliates from using your information to market to you,

?
Sharing for nonaffiliates to market you.

What happens when I limit sharing
for an account I hold jointly with
someone else?

Your choices will apply to everyone on your account.

Definitions

Affiliates
Companies related by common ownership or control. They can be
financial and nonfinancial companies.

?
University Financial Corp. dba Sunrise Community Banks.

?
Franklin National Bank

?
Park Midway Bank, NA

Nonaffiliates
Companies not related by common ownership or control. They can be
financial or nonfinancial companies.
University National Bank does not share with nonaffiliates so they can
market to you.

Joint marketing
A formal joint marketing agreement between nonaffiliated financial
companies that together market financial products or services to you.
University National Bank does not jointly market.

Other Important Information

This notice is adopted in recognition of our obligations under Title V of Gramm-Leach Bliley Act of 1999.
This Notice applies only to individuals who have applied for a tax-related bank product.

SBIA0912 01/05/11

Shonda L Pierce 258-67-8100

The Intuit Electronic Postmark shows the date and time Intuit received
your federal tax return. The Intuit Electronic Postmark documents the
filing date of your income tax return, and the electronic postmark
information should be kept on file with your tax return and other
tax-related documentation.
There are two important aspects of the Intuit Electronic Postmark:
1. THE INTUIT ELECTRONIC POSTMARK.
The electronic postmark shows the date and time Intuit received the
federal return, and is deemed the filing date if the date of the
electronic postmark is on or before the date prescribed for filing of the
federal individual income tax return.
TIMELY FILING:
For your federal return to be considered filed on time, your return must
be postmarked on or before midnight April 18, 2011. Intuit’s electronic
postmark is issued in the Pacific Time (PT) zone. If you are not filing
in the PT zone, you will need to add or subtract hours from the Intuit
Electronic Postmark time to determine your local postmark time. For
example, if you are filing in the Eastern Time (ET) zone and you
electronically file your return at 9 AM on April 18, 2011, your Intuit
electronic postmark will indicate April 18, 2011, 6 AM. If your federal
tax return is rejected, the IRS still considers it filed on time if the
electronic postmark is on or before April 18, 2011, and a corrected
return is submitted and accepted before April 22, 2011. If your return is
submitted after April 22, 2011, a new time stamp is issued to reflect
that your return was submitted after the IRS deadline and, consequently,
is no longer considered to have been filed on time.
If you request an automatic six-month extension, your return must be
electronically postmarked by midnight October 15, 2011. If your federal
tax return is rejected, the IRS will still consider it filed on time if
the electronic postmark is on or before October 15, 2011, and the
corrected return is submitted and accepted by October 20, 2011.
2. THE ACCEPTANCE DATE.
Once the IRS accepts the electronically filed return, the acceptance date
will be provided by the Intuit Electronic Filing Center. This date is
proof that the IRS accepted the electronically filed return.
ELECTRONIC POSTMARK - CERTIFICATION OF ELECTRONIC FILING
TAXPAYER:
PRIMARY SSN:
FEDERAL RETURN SUBMITTED:
FEDERAL RETURN ACCEPTANCE DATE:

FDIU0401 12/14/10

Shonda L Pierce
258-67-8100
February 03, 2011 09:46 AM PST
02/03/2011

Electronic Filing Instructions for your 2010 Georgia Tax Return

Important: Your taxes are not finished until all required steps are completed.

Declaration Control Number: 00-210062-66204-1 Accepted: 02/07/2011

Shonda L Pierce
750 Corder Rd.
Warner Robins, GA 31088

Page 1 of 1

|

Balance
|
Your Georgia state tax return (Form 500) shows a refund due to you in

Due/
|
the amount of $229.00. Your tax refund should be direct deposited

Refund
|
into your account within 8 to 14 days after your return is accepted.

|
The account information you entered - Account Number: 3573870189

|
Routing Transit Number: 061000227.
_
|
_

|

Where’s My
|
Before you call the Georgia Department of Revenue with questions

Refund?
|
about your refund, give them 8 to 14 days processing time from the

|
date your return is accepted. If then you have not received your

|
refund, or the amount is not what you expected, contact the Georgia

|
Department of Revenue directly at 1-404-656-6286 . From outside of

|
Georgia use 1-877-602-8477. You can also visit the Georgia Department

|
of Revenue web site at https://www.dor.ga.gov/WMRefund/index.aspx.
_
|
_

|

What You
|
Sign and date Form GA-8453 within 1 day of acceptance.

Need to
|

Sign
|

_
|
_

|

Do Not
|
Do not mail a paper copy of your tax return. Since you filed

Mail
|
electronically, the Georgia Department of Revenue already has your

|
return.
_
|
_

|

What You
|
Your Electronic Filing Instructions (this form)

Need to
|
- Form GA-8453 and attachment(s)

Keep
|
Printed copy of your state and federal returns
_
|
_

|

2010
|
Taxable Income $ 6,904.00

Georgia
|
Total Tax $ 227.00

Tax
|
Total Payments/Credits $ 383.00

Return
|
Amount to be Refunded $ 229.00

Summary
|

_
|
_

GEORGIA INDIVIDUAL INCOME TAX DECLARATION
SUMMARY OF AGREEMENT BETWEEN TAXPAYER AND ERO OR PAID PREPARER

First Name and Initial Last Name Social Security Number
If Joint Return, Spouse’s First Name and Initial Spouse’s Last Name Spouse’s Social Security Number
Home Address (number and street) Apartment Number Daytime Telephone Number
City, Town or Post Office, State and ZIP Code

PART I TAX RETURN INFORMATION

1
Federal Adjusted Gross Income (Form 500, Line 8; Form 500EZ, Line 1)
1
2
Georgia Taxable Income (Form 500, Line 15; Form 500EZ, Line 3)
2
3
Net Georgia Tax (Form 500, Line 18; Form 500EZ, Line 4)
3
4
Refund (Form 500, Line 37; Form 500EZ, Line 20)
4
5
Balance Due (Form 500, Line 36; Form 500EZ, Line 19)
5

PART II DECLARATION OF TAXPAYER(S)

Under penalties of perjury, I declare that the information I have provided to my Electronic Return Originator (ERO) and/or Online Service
Provider and/or transmitter and the amounts shown in Part I agree with the amounts shown on the corresponding lines of the electronic portion
of my 2010 Georgia Income Tax Return. I declare that I have examined my tax return, including accompanying schedules and statements, and
to the best of my knowledge and belief, my return is is true, correct, and complete. I consent that the electronic portion of my return may be
sent by my ERO/Online Service Provider/transmitter.

SIGN
HERE

A

TAXPAYER’S SIGNATURE
Date SPOUSE’S SIGNATURE
(if joint return, both must sign) Date

PART III DECLARATION OF ELECTRONIC RETURNS ORIGINATOR AND PAID PREPARER

I DECLARE THAT I HAVE REVIEWED THE ABOVE TAXPAYER’S RETURN AND THAT THE ENTRIES ON THE GA-8453 ARE COMPLETE AND
CORRECT TO THE BEST OF MY KNOWLEDGE.

ERO’s Signature
Date
Firm’s Name Check if also paid preparer
Address FEIN/PTIN

ERO’s
Use
Only

SSN/TIN

IF PREPARED BY ANY PERSON OTHER THAN THE TAXPAYER, THIS DECLARATION IS BASED ON ALL INFORMATION OF WHICH THE
TAXPAYER HAS KNOWLEDGE.

Paid Preparer’s Signature
Date
Firm’s Name FID/TIN
Address SSN/TIN

Paid
Preparer’s
Use Only

Form
GA-8453 (REV 8/10)
GAIA0701 09/01/10

IRS DCN OR SUBMISSION ID

' '

2010

KEEP WITH YOUR RECORDS
PLEASE DO NOT MAIL! KEEP WITH YOUR RECORDS

GA-8453

00 21006266204 1
GA-8453

Shonda L Pierce 258-67-8100
750 Corder Rd. 91
Warner Robins GA 31088
14,904.
6,904.
154.
229.
Self Prepared

1100401611

Georgia Form 500
(Rev 10/10)

Individual Income Tax Return

Georgia Department of Revenue

2010 (Approved software version)
DEL EXT

ADDRESS (NUMBER AND STREET or PO BOX) (Use 2nd address line for Apt, Suite or Building number)
CHECK IF ADDRESS
HAS CHANGED

2
CITY STATE ZIP CODE
3

500 UET Exception
Attached
(COUNTRY IF FOREIGN)

GAIA0112 12/22/10 Residency Status

4
Enter your Residency Status with the appropriate number
4
1 FULL- YEAR RESIDENT 2 PART- YEAR RESIDENT TO 3 NONRESIDENT

Part-Year Residents and Nonresidents must omit Lines 9 thru 14 and use Schedule 3 of Form 500, page 6

Filing Status

5 Enter Filing Status with appropriate letter (See instructions) 5
A
Single B Married filing joint C Married filing separate (Spouse’s social security number must be entered above) D
Head of Household or Qualifying Widow(er)

6 Number of exemptions (Check appropriate box(es) and enter total in 6c.) 6a
Yourself 6b Spouse
6c
7 Dependents (If you have more than 3 dependents, attach a list of additional dependents)
YOUR FIRST NAME MI YOUR SOCIAL SECURITY NUMBER
1 Special Program Code
See instructions
LAST NAME SUFFIX
SPOUSE’S FIRST NAME MI SPOUSE’S SOCIAL SECURITY NUMBER

DEPARTMENT USE ONLY

LAST NAME SUFFIX
Version 1
First Name, MI. Last Name
Social Security Number Relationship to You
First Name, MI. Last Name
Social Security Number Relationship to You
First Name, MI. Last Name
Social Security Number Relationship to You

Page 1

SHONDA L 258-67-8100
PIERCE
750 CORDER RD
APT NO 91
WARNER ROBINS GA 31088
1
A

X
1
SARIAH J JOHNSON
675-44-4711 DAUGHTER

13
Subtract either Line 11c or Line 12c from Line 10; enter balance
13
14a
Number on Line 6c multiplied by $2,700
14a
14b
Number on Line 7a multiplied by $3,000
14b
14c
Add Lines 14a and 14b. Enter total
14c
15
Georgia taxable income (Line 13 less Line 14c or Schedule 3, Line 14)
15
16
Tax (Use Tax Table in the instructions)
16
17
Credits from Schedule 2, Page 5, Line 12 of Form 500
(Enter total but not more than the amount on Line 16)
17
18
Balance (Line 16 less Line 17) if zero or less than zero, enter zero
18
19 Georgia Income Tax Withheld

(Enter Tax Withheld Only and enclose W-2s, 1099s, etc.)
19
20 Estimated Tax for 2010 and Form IT-560 20

1100401621

7 a
Number of Dependents (DO NOT include yourself or your spouse)
7 a
b
Add Lines 6c and 7a. Enter total
7 b
If the amount on line 8, 9, 10, 13 or 15 is negative, check box.
8
Federal adjusted gross income (From Federal Form 1040, 1040A or 1040EZ)
8
(Do not use FEDERAL TAXABLE INCOME) If the amount on Line 8 is $40,000 or more, or your gross income is less than your W-2s, you
must enclose a copy of your Federal Form 1040 Pages 1 and 2.
9
Adjustments from Schedule 1 (See instructions)
9
10
Georgia adjusted gross income (Net total of Line 8 and Line 9)
10
11
Standard Deduction (Do not use FEDERAL STANDARD DEDUCTION) see instructions
11a
b
Self: 65 or over? Blind? Spouse: 65 or over? Blind?
Total of boxes x 1,300 =
11b
c
Total Standard Deduction (Line 11a + Line 11b)
11c
Use EITHER Line 11c OR Line 12C (Do not write on both lines)
12
Total Itemized Deductions used in computing Federal Taxable Income. If you use itemized deductions,
you must enclose Federal Schedule A

a
Federal Itemized Deductions (Schedule A-Form 1040)
12a
b
Less adjustments: see instructions for Line 12
12b
c
Georgia Total Itemized Deductions
12c

Georgia Form 500

Individual Income Tax Return

Georgia Department of Revenue

2010

2010 GA 004 T1 10

GAIA0112 12/22/10

YOUR SOCIAL SECURITY NUMBER

Version 1

Page 2

SHONDA L PIERCE
258-67-8100
1
2
14904
14904
2300
2300
12604
1 2700
1 3000
5700
6904
227
73
154
383
INTUIT 01 1030

TAXPAYER EMAIL ADDRESS

1100401631
YOUR SOCIAL SECURITY NUMBER

Georgia Form 500

Individual Income Tax Return

Georgia Department of Revenue

2010

(PAYMENT) GEORGIA DEPARTMENT OF REVENUE
PROCESSING CENTER
PO BOX 740399,
ATLANTA, GA 30374-0399
(REFUND) GEORGIA DEPARTMENT OF REVENUE
PROCESSING CENTER
PO BOX 740380,
ATLANTA, GA, 30374-0380

ENCLOSE ALL ITEMS IN RETURN ENVELOPE.
DO NOT
STAPLE YOUR CHECK, W-2’S OR TAX RETURN

30
Georgia National Guard Foundation
(No gift of less than $1.00) 30
31
Dog and Cat Sterilization Fund
(No gift of less than $1.00) 31
32
Save the Cure Fund
(No gift of less than $1.00) 32
33
Georgia Student Finance Authority Fund
(No gift of less than $1.00) 33

GAIA0103 11/05/10

34
Form 500 UET
(Estimated tax penalty) 34
(If you owe)
Add Lines 23, 26 thru 34

35 THIS IS THE AMOUNT YOU OWE 35
22
Total prepayment credits
(Add Lines 19 and 20) 22
23
If Line 18 exceeds Line 22 enter BALANCE DUE STATE
23
24
If Line 22 exceeds Line 18 enter OVERPAYMENT amount
24
25 Amount to be credited to 2011 ESTIMATED TAX 25
26
Georgia Wildlife Conservation Fund
(No gift of less than $1.00) 26
27
Georgia Children and Elderly Fund
(No gift of less than $1.00) 27
28
Georgia Cancer Research Fund
(No gift of less than $1.00) 28
29
Statewide Land Conservation Program
(No gift of less than $1.00) 29
PHONE NUMBER

Taxpayer’s Signature (Check box if deceased)
DATE

Spouse’s Signature (Check box if deceased)
DATE

NAME OF PREPARER OTHER THAN TAXPAYER

Do you want to authorize DOR to discuss
this return with the named preparer.
YES NO

PREPARER’S FEIN PREPARER’S SSN/PTIN PHONE NUMBER

Signature of Preparer

21 Department Use Only DO NOT WRITE IN THIS BOX
36 (If you are due a refund)
Subtract the sum of Lines 25 thru 34 from Line 24

THIS IS YOUR REFUND 36

Georgia Public Revenue Code Section 48-2-31 stipulates that taxes shall be paid in lawful money of the United States, free of any expense to the State of Georgia. Under penalty of
perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief it is true, correct and complete.
Declaration of preparer (other than taxpayer) is based on all information of which the preparer has knowledge.

Version 1

Page 3

SHONDA L PIERCE
258-67-8100
383
229
0
229
SELF-PREPARED

GAIA0145 11/17/10

SCHEDULE 1 ADJUSTMENTS to INCOME BASED on GEORGIA LAW
(see instructions)

ADDITIONS to INCOME
7
Social Security Benefits (Taxable portion from Federal return)
7
8
Georgia Higher Education Savings Plan
8
9
Interest on United States Obligations (see instructions)
9
10
Other Adjustments (specify)
Adjustment Amount
Adjustment Amount
Adjustment Amount
Adjustment Amount

Total
10
11
Total Subtractions (enter sum of Lines 6-10 here)
11
12
Net Adjustments (Line 5 less Line 11.)
Enter Net Total here and on Line 9 of Page 2 (+ or -) of Form 500
12

1100401641

1
Interest on Non-Georgia Municipal and State Bonds
1
2
Lump-Sum Distributions
2
3
Federal deduction for income attributable to domestic production activities
3

(IRC Section 199)

4
Other(specify)
4
5
Total Additions (enter sum of Lines 1-4 here)
5
SUBTRACTION from INCOME
6
Retirement Income Exclusion (see instructions)

a
Self: Date of Birth Date of Disability: Type of Disability:

6 a
b
Spouse: Date of Birth Date of Disability: Type of Disability:

6 b

Georgia Form 500

Individual Income Tax Return

Georgia Department of Revenue

2010

YOUR SOCIAL SECURITY NUMBER
Version 1

Page 4

SHONDA L PIERCE
258-67-8100

GAIA0145 11/17/10

1
Other State(s) Tax Credit (see instructions)
1

1100401651
YOUR SOCIAL SECURITY NUMBER
10
Any additional pass-through credits claimed (attach schedule)
10

Georgia Form 500

Individual Income Tax Return

Georgia Department of Revenue

2010

Pass Through Credits from Ownership of Sole Proprietor, S Corp., LLC or Partnership Interest and Other Credits

You must list the appropriate Credit Type Code in the space provided. If you claim more than four credits, enclose a schedule.
Enter the schedule total on Line 10. See instructions for a list of available credits and their applicable codes.

6 COMPANY NAME CREDIT CODE TYPE
OWNERSHIP FEIN CREDIT CLAIMED ON THIS RETURN
Version 1

Page 5

SCHEDULE 2 CREDITS for LINE 17, PAGE 2
(see instructions)

3
Low and Zero Emission Vehicle Credit
3
4
Qualified Education Expense Credit (Individual/Non pass through)
4
5
Clean Energy Property Credit (Individual/Non pass through)
5
2
Credits from Form IND-CR (Rural Physicians Credit, Disabled Person Home Purchase or Retrofit Credit,
Driver Education Credit, Disaster Assistance Credit, Qualified Caregiving Expense Credit, Georgia
National Guard/Air National Guard Credit, Child and Dependent Care Expense Credit, Adoption Credit,
Eligible Single-Family Residence Credit)
2
7 COMPANY NAME CREDIT CODE TYPE
OWNERSHIP FEIN CREDIT CLAIMED ON THIS RETURN
8 COMPANY NAME CREDIT CODE TYPE
OWNERSHIP FEIN CREDIT CLAIMED ON THIS RETURN
9 COMPANY NAME CREDIT CODE TYPE
OWNERSHIP FEIN CREDIT CLAIMED ON THIS RETURN
12
Enter the total of Lines 1 through 11 here and on Line 17, Page 2 of 500 form
12
11

Low Income Credit (see
instructions)
11a 11b 11c

SHONDA L PIERCE
258-67-8100
57
2 8 16
73

YOUR FIRST NAME MI YOUR SOCIAL SECURITY NUMBER
LAST NAME SUFFIX SPOUSE’S SOCIAL SECURITY NUMBER
ADDRESS (NUMBER AND STREET, or P.O. BOX)(Use 2nd address line for Apt, Suite or Building Number)
CHECK IF ADDRESS HAS CHANGED
DEPARTMENT USE ONLY

CITY
(PLEASE INSERT SPACE IF CITY HAS MULTIPLE NAMES)
STATE ZIP CODE

Part 1
'
Disabled Person Home Purchase or Retrofit Credit

O.C.G.A. Subsection 48-7-29.1 provides a disabled person credit equal to the lesser of $500 per residence or the taxpayer’s income tax liability
for the purchase of a new single-family home that contains all of the accessibility features listed below. It also provides a credit equal to the
lesser of the cost or $125 to retrofit an existing single-family home with one or more of these features. The disabled person must be the
taxpayer or the taxpayer’s spouse if a joint return is filed. Qualified features are:

GAIA1212 01/04/11

Georgia Form IND-CR (Rev. 11/10)

State of Georgia Individual Credit Form

Georgia Department of Revenue (Approved software version)

2010
' Enclose with Form 500
'

1
Purchase of a home that contains all four accessibility features OR
total of accessibility
features added to retrofit a home (up to $125 per feature)
G
1
2
Maximum credit per residence G 2
500

3
Enter the lesser of Line 1 or Line 2 and include in Part 10 G
3

Part 2
'
Child and Dependent Care Expense Credit

O.C.G.A. Subsection 48-7-29.10 provides taxpayers with a credit for qualified child & dependent care expenses. The credit is a percentage
of the credit claimed and allowed under Internal Revenue Code Subsection 21 and claimed by the taxpayer on the taxpayer’s Federal income
tax return. The credit is computed as follows:

1
Amount of child & dependent care expense credit claimed on Federal Form 1040 G
1
2
Georgia allowable rate G 2
30%

3
Allowable Child & Dependent Care Expense Credit (Line 1 x .30)
Enter here and include in Part 10
G
3

1105901611

X
One no-step entrance allowing access into the residence.

X
Interior passage doors providing at least a 32-inch-wide opening.

X
Reinforcements in bathroom walls allowing installation of grab bars around the toilet, tub, and shower, where such facilities
are provided.

X
Light switches and outlets placed in accessible locations.
To qualify for this credit, the disabled person must be permanently disabled and have been issued a permanent parking permit by the
Department of Revenue or have been issued a special permanent parking permit by the Department of Revenue. For more information, see
Regulation 560-7-8-.44.

Version 1

Page 1

SHONDA L
PIERCE
258-67-8100
750 CORDER RD
APT NO 91
WARNER ROBINS GA 31088
191
57

GAIA1212 01/04/11

Part 3
'
Georgia National Guard/Air National Guard Credit

O.C.G.A. Subsection 48-7-29.9 provides a tax credit for Georgia residents who are members of the National Guard or Air National Guard and
are on active duty full time in the United States Armed Forces, or active duty training in the United States Armed Forces for a period of more
than 90 consecutive days. The credit shall be claimed and allowed in the year in which the majority of such days are served. In the event an
equal number of consecutive days are served in two calendar years, then the exclusion shall be claimed and allowed in the year in which the
ninetieth day occurs. The credit shall apply with respect to each taxable year in which such member serves for such qualifying period of time.
The credit cannot exceed the amount expended for qualified life insurance premiums nor the taxpayer’s income tax liability. Qualified life
insurance premiums are the premiums paid for insurance coverage through the service member’s Group Life Insurance Program administered
by the United States Department of Veterans Affairs. Any unused tax credit is allowed to be carried forward to the taxpayer’s succeeding year’s
tax liability.

Georgia Form IND-CR

State of Georgia Individual Credit Form

Georgia Department of Revenue

2010

Part 4
'
Qualified Caregiving Expense Credit

O.C.G.A Subsection 48-7-29.2 provides a qualified caregiving expense credit equal to 10 percent of the cost of qualified caregiving expenses
for a qualifying family member. The credit cannot exceed $150. Qualified services include Home health agency services, personal care
services, personal care attendant services, homemaker services, adult day care, respite care, or health care equipment and other supplies
which have been determined by a physician to be medically necessary. Services must be obtained from an organization or individual not related
to the taxpayer or the qualifying family member. The qualifying family member must be at least age 62 or determined disabled by the Social
Security Administration. A qualifying family member includes the taxpayer or an individual who is related to the taxpayer by blood, marriage or
adoption. Qualified caregiving expenses do not include expenses that were subtracted to arrive at Georgia net taxable income or for which
amounts were excluded from Georgia net taxable income. There is no carryover or carry-back available. The credit cannot exceed the
taxpayer’s income tax liability. For more information, see Regulation 560-7-8-.43.
Qualifying Family Member Name:
Name:

1105901621

YOUR SOCIAL SECURITY NUMBER
1
Enter amount of qualified life insurance premiums and include in Part 10 G
1

SS# Relationship
Age, if 62 or over If disabled, date of disability

1
Qualified caregiving expenses G
1
2
Percentage limitation G 2
10%

3
Line 1 multiplied by Line 2 G
3
4
Maximum credit G 4
150

5
Enter the lesser of Line 3 or Line 4 and include in Part 10 G
5

Page 2

Version 1
SHONDA L PIERCE
258-67-8100

Part 6
'
Disaster Assistance Credit

O.C.G.A. Subsection 48-7-29.4 provides for a credit for a taxpayer who receives disaster assistance during a taxable year from the Georgia
Emergency Management Agency or the Federal Emergency Management Agency. The amount of the credit is equal to $500 or the actual
amount of the disaster assistance, whichever is less. The credit cannot exceed the taxpayer’s income tax liability. Any unused tax credit can be
carried forward to the succeeding years’ tax liability but cannot be carried back to the prior years’ tax liability. The approval letter from the
disaster assistance agency must be enclosed with the return.
The following types of assistance qualify:

X
Grants received from the Department of Human Services Individual and Family Grant Program.

X
Grants from GEMA and/or FEMA.

X
Loans from the Small Business Administration that are due to disasters declared by the President or Governor.
Disaster assistance agency

1
Date assistance was received G
1
2
Amount of the disaster assistance received G
2
3
Maximum credit G 3
500

4
Enter the lesser of Line 2 or Line 3 and include in Part 10 G
4

GAIA1234 01/04/11

Georgia Form IND-CR

State of Georgia Individual Credit Form

Georgia Department of Revenue

2010

Part 5
'
Driver Education Credit

O.C.G.A. Subsection 48-7-29.5 provides for a driver education credit. This is a credit for an amount paid for a dependent minor child for a
successfully completed course of driver education at a private driver training school licensed by the Department of Driver Services under
Chapter 13 of Title 43, ’The Driver Training School License Act,’ The amount of the credit is equal to $150 or the actual amount paid, whichever
is less. A private driver training school is one that primarily engages in offering driving instruction.
This does not include schools owned or
operated by local, state, or federal governments. An amount paid for a completed course of driver education to a private or public high
school does not qualify for this credit.
A completed course of driver education includes additional courses offered by private driver training
schools such as defensive driver education. This tax credit is only allowed once for each dependent minor child of a taxpayer. The amount of
the tax credit cannot exceed the taxpayer’s income tax liability. The credit is not allowed with respect to any driver education expenses either
deducted or subtracted by the taxpayer to arrive at Georgia taxable net income or with respect to any driver education expenses for which
amounts were excluded from Georgia net taxable income. Any unused tax credit cannot be carried forward to any succeeding years’ tax liability
and cannot be carried back to the prior years’ tax liability. Visit
www.dds.ga.gov/Training/index.aspx.

Name of private driver training school
Name of dependent minor child
Birth Date SS#

1
Date of Successful Completion G
1
2
Amount paid for the successfully completed course G
2
3
Maximum credit G 3
150

4
Enter the lesser of Line 2 or Line 3 and include in Part 10 G
4

1105901631

Version 1

Page 3

YOUR SOCIAL SECURITY NUMBER

SHONDA L PIERCE 258-67-8100

GAIA1234 01/04/11

Part 7
'
Rural Physicians Credit

O.C.G.A. Subsection 48-7-29 provides for a $5,000 tax credit for rural physicians. The tax credit may be claimed for not more than five years.
There is no carryover or carry-back available. The credit cannot exceed the taxpayer’s income tax liability. In order to qualify, the physician
must meet the following conditions:

1
The physician must have started working in a rural county after July 1, 1995. If the physician worked in a rural county prior to that date, a
period of at least three years must have elapsed before the physician returns to work in a rural county.

2
The physician must practice and reside in a rural county. For taxable years beginning on or after January 1, 2003, a physician qualifies for
the credit if they practice in a rural county and reside in a county contiguous to a rural county. A rural county is defined as one with 65 or
fewer persons per square mile according to the United States Decennial Census of 1990 or any future such census. For taxable years
beginning on or after January 1, 2002, the United States Decennial Census of 2000 is used.

3
The physician must be licensed to practice medicine in Georgia, primarily admit patients to a rural hospital, and practice in the fields of
family practice, obstetrics and gynecology, pediatrics, internal medicine, or general surgery. A rural hospital is defined as an acute-care
hospital located in a rural county that contains 80 or fewer beds. For taxable years beginning on or after January 1, 2003, a rural hospital
is defined as an acute-care hospital located in a rural county that contains 100 or fewer beds.
For more information, see Regulation 560-7-8-.20.

1
County of residence G
1
2
County of practice G
2
3
Type of practice G
3
4
Date started working as a rural physician G
4
5
Number of hospital beds in the rural hospital G
5
6
Rural physicians credit, enter $5,000 and include in Part 10 G
6

Georgia Form IND-CR

State of Georgia Individual Credit Form

Georgia Department of Revenue

2010

1105901641

Page 4

YOUR SOCIAL SECURITY NUMBER
Version 1

Part 8
'
Adoption of a Foster Child Credit

1
Georgia Code Section 48-7-29.15 provides an income tax credit for the adoption of a qualified foster child. The amount of
the credit is $2,000 per qualified foster child per taxable year, commencing with the year in which the adoption becomes
final, and ending in the year in which the adopted child attains the age of 18. This credit applies to adoptions occuring in
the taxable years beginning on or after January 1, 2008.
Enter $2,000 per qualified foster child and include in Part 10
G
1

SHONDA L PIERCE
258-67-8100

Part 10
'
Total Section

1
Add Part 1, Line 3; Part 2, Line 3; Part 3, Line 1; Part 4, Line 5; Part 5, Line 4;
Part 6, Line 4; Part 7, Line 6; Part 8, Line 1; and Part 9, Line 3.
Enter the total here and on Form 500, Page 5, Schedule 2, Line 2
G
1

GAIA1234 01/04/11

Part 9
'
Eligible Single-Family Residence Tax Credit

O.C.G.A. Subsection 48-7-29.17 provides taxpayers a credit for the purchase of an eligible single-family residence located in Georgia.
An eligible single-family residence is a single-family structure (including a condominium unit as defined in O.C.G.A. Subsection 44-3-71)
that is occupied for residential purposes by a single family, that is:

a)
Any residence (including a new residence, one occupied at the time of sale, or a previously occupied residence) that was
for sale prior to May 11, 2009 and that remained for sale after May 11, 2009; or

b)
A residence with respect to which a foreclosure event has taken place and which is owned by the mortgagor or the mortgagor’s
agent; or

c)
An owner-occupied residence with respect to which the owner’s acquisition indebtedness was in default on or before March 1, 2009.
Acquisition indebtedness is debt incurred in acquiring, constructing, or substantially improving a qualified residence and which is secured
by such residence. Refinanced debt is acquisition debt if at least a portion of such debt refinances the principal amount of existing
acquisition indebtedness.
A taxpayer is allowed the tax credit for a purchase of one eligible single-family residence made between June 1, 2009 and
November 30, 2009. The credit amount is the lesser of 1.2 percent of the purchase price of the eligible single-family residence
or $1,800.00. The amount of the tax credit that may be claimed and allowed in a single tax year cannot exceed the lesser
of 1/3 of the credit or the taxpayer’s income tax liability. Any unused tax credit can be carried forward but cannot be carried back.

1
Total credit. (Enter the amount from 2009 IND-CR, Part 9, Line 5.) G
1
2
Maximum allowed per year G 2
33.33%

3
Credit allowed, multiply Line 1 by Line 2, enter here and include in part 10 G
3

Georgia Form IND-CR

State of Georgia Individual Credit Form

Georgia Department of Revenue

2010

1105901651

Page 5

YOUR SOCIAL SECURITY NUMBER
Version 1

The taxpayer must have been claimed the credit in 2009 in order to claim the unused credit below.

SHONDA L PIERCE
258-67-8100
57